Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

102 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

104 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

112 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

151 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

228 Public Employee & Pension/Retiree 3/30/2021

Department of Correction and Rehabilitation & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

269 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

297 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

380 Tax Refund 10/1/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

411 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

460 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

462 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

498 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

514 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

517 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

539 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

561 Public Employee 5/4/2021 Department of Public Safety Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

593 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

638 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 1 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

683 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

697 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

946 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

965 Public Employee & Pension/Retiree 11/11/2020

Department of Labor and Human Resources and Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

979 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

1048 Public Employee & 

Pension/Retiree2 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

1059 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

1300 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

1375 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

1429 Public Employee 6/10/2021 Department of Public Safety Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

1463 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

1511 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

1661 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Health, Hospital Regional - Caguas, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

1669 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

1702 Pension/Retiree1 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

1772 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

1840 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

1853 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 2 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

1881 Public Employee & Pension/Retiree 11/11/2020

Department of Family, Department of Social Services & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

2014 Public Employee & Pension/Retiree 7/13/2021 Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

2057 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

2061 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

2133 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

2135 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

2233 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

2246 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

2251 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

2312 Public Employee & Pension/Retiree 6/10/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

2313 Pension/Retiree 11/13/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

2314 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

2315 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

2318 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

2335 Public Employee & Pension/Retiree 6/10/2021

Department of Natural and Environmental Resources, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

2373 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

2399 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

2401 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 3 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

2426 Public Employee 12/20/2022 Public Building Authority Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 2534 Public Employee 5/4/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

2548 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

2587 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

2662 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

2676 Public Employee & Union Grievance 7/29/2022 Department of Transportation and Public Works Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

2703 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

2706 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

2733 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

2774 Public Employee & Pension/Retiree 6/10/2021 Office of Court Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

2781 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

2873 Public Employee & Pension/Retiree 7/29/2022

Department of Transportation and Public Works, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

2896 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

2897 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

2935 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

2962 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

3032 Public Employee & 

Pension/Retiree2 5/4/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

3049 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 4 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

3050 Public Employee & Pension/Retiree 11/11/2020

Department of Transportation and Public Works & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

3057 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

3070 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

3072 Public Employee 12/20/2022 PR Police Bureau, PR Police Department Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 3141 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

3169 Public Employee & 

Pension/Retiree4 7/10/2020

Puerto Rico Police Bureau and Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

3185 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

3209 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

3265 Public Employee & Pension/Retiree 6/24/2022

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

3281 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

3312 Public Employee & Pension/Retiree 6/10/2021 Department of Justice Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

3346 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

3378 Public Employee & 

Pension/Retiree2 5/4/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

3402 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

3423 Public Employee & Pension/Retiree 6/10/2021 Department of Treasury Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

3426 Pension/Retiree 4/21/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

3446 Public Employee & Pension/Retiree 6/24/2022

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

3454 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 5 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

3458 Public Employee & Pension/Retiree 6/10/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

3461 Pension/Retiree 11/13/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

3486 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

3567 Public Employee & 

Pension/Retiree2 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

3573 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

3643 Public Employee 5/4/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

3754 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

3884 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

3916 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

3967 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

3987 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

4002 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

4096 Public Employee & 

Pension/Retiree2 3/30/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

4118 Public Employee & 

Pension/Retiree4 7/10/2020 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

4147 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

4150 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

4191 Public Employee 3/30/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

4216 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 6 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

4233 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

4256 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

4465 Public Employee & Pension/Retiree 6/10/2021 Department of Treasury Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

4473 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

4511 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

4554 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

4555 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

4556 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

4570 Pension/Retiree 11/11/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

4582 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

4609 Public Employee 6/10/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

4712 Pension/Retiree 11/13/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

4732 Public Employee & 

Pension/Retiree4 7/10/2020

Department of Justice, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

4874 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

4900 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

4903 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

4961 Public Employee 7/29/2022 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

5015 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 7 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

5089 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

5117 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

5178 Public Employee & Pension/Retiree 7/2/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

5219 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

5265 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

5278 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

5285 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

5378 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

5381 Public Employee 5/4/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

5417 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

5448 Public Employee 11/11/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

5466 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

5490 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

5499 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

5540 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

5544 Public Employee 7/29/2022 Department of Education Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

5582 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

5583 Public Employee & Pension/Retiree 10/22/2020 Administration of the Government Retirement Systems and the Judiciary, Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

5588 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 8 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

5592 Pension/Retiree 11/11/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

5594 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 5596 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

5607 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

5610 Public Employee & 

Pension/Retiree2 11/11/2020 Department of Public Safety Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

5616 Public Employee & Pension/Retiree 6/10/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

5658 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

5668 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

5673 Public Employee, Pension/Retiree & Union Grievance 6/24/2022

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

5678 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review7 

5679 Public Employee, Pension/Retiree & Union Grievance 6/24/2022

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

5716 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

5724 Public Employee3 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

5768 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

5773 Public Employee & Union Grievance 7/29/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

5789 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

5813 Public Employee & Pension/Retiree 6/10/2021 Environmental Quality Board, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

5843 Public Employee & Union Grievance 7/29/2022 Highway and Transportation Authority Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

5876 Public Employee & 

Pension/Retiree2 5/4/2021

Child Support Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 9 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

5887 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

5892 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

5944 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

5996 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

5999 Public Employee & Pension/Retiree 6/24/2022

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

6023 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

6026 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

6047 Public Employee & Pension/Retiree 6/24/2022

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

6078 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

6080 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

6123 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

6148 Public Employee & Union Grievance 7/29/2022 Highway and Transportation Authority Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

6150 Public Employee 4/21/2021 Agency Not Provided Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

6155 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

6165 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

6171 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

6174 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

6175 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

6183 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 10 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

6202 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

6209 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

6214 Public Employee & 

Pension/Retiree2 5/4/2021 State Expert Rio Piedras Puerto Rico Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

6227 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

6245 Public Employee & Union Grievance 7/29/2022 Highway and Transportation Authority Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

6255 Public Employee 5/4/2021 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

6292 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

6302 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

6307 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

6321 Public Employee 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

6358 Public Employee 5/4/2021 National Guard of Puerto Rico Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

6368 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

6375 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

6386 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

6409 Union Grievance & Pension/Retiree 6/10/2021 Department of Treasury Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

6502 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

6524 Public Employee & Union Grievance 7/29/2022 National Guard of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

6543 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 11 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

6712 Public Employee 6/10/2021 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

6713 Pension/Retiree6 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

6726 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

6759 Public Employee3 6/10/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

6766 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

6782 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

6848 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

6851 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

6890 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

6921 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

6934 Public Employee & Pension/Retiree 6/10/2021 Corps of Firefighters Bureau, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A Y Y N/A N N/A 

6950 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

6985 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

7044 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

7067 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

7131 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

7169 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

7209 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 12 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

7273 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

7288 Public Employee 5/4/2021 Administration of Correction, Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

7322 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

7323 Pension/Retiree 12/20/2022

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A N N/A 

7333 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

7370 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

7402 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

7403 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

7437 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

7486 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

7578 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

7655 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

7722 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

7752 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

7755 Public Employee & 

Pension/Retiree2 11/13/2020

Vocational Rehabilitation Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

7838 Public Employee 5/4/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

7913 Pension/Retiree 12/20/2022

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A N N/A 

7937 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

7939 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 13 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

7942 Pension/Retiree 11/13/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

7947 Public Employee 7/29/2022 Department of Public Safety, Puerto Rico Police Bureau Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

7995 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

8056 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

8062 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

8107 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

8146 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

8161 Public Employee & Pension/Retiree 10/22/2020

Family and Children Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

8197 Union Grievance 10/22/2020 Department of Family, Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

8247 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

8367 Public Employee & 

Pension/Retiree4 7/10/2020 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

8414 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

8485 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

8494 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

8574 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

8586 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

8609 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

8625 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 14 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

8639 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

8643 Public Employee & 

Pension/Retiree2 6/10/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

8655 Public Employee 3/30/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

8657 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

8750 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

8813 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

8830 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

8915 Public Employee & 

Pension/Retiree2 5/4/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

8931 Public Employee 7/13/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

9006 Public Employee & Pension/Retiree 6/10/2021 Department of Justice Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

9067 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

9126 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

9208 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

9209 Pension/Retiree 11/11/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

9299 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

9310 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

9410 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

9501 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 15 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

9609 Public Employee & Union Grievance 7/29/2022 Department of Justice Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

9721 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

9775 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

9814 Public Employee 12/20/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 9882 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

9931 Public Employee 7/29/2022 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

9963 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

9975 Union Grievance 6/10/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

10019 Public Employee & 

Pension/Retiree2 5/4/2021 Government Ethics Office Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

10137 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

10160 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

10180 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

10187 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

10189 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

10204 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

10205 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

10209 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

10422 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

10727 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 16 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

10733 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

10776 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

10813 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Department of Labor and Human Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

10835 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

10844 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

10855 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

10877 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

10952 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

11014 Tax Refund 10/1/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

11032 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

11079 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

11118 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

11203 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

11264 Public Employee3 3/30/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

11337 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 11353 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

11366 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

11368 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 11376 Public Employee & Pension/Retiree 10/22/2020

Vocational Rehabilitation Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 17 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

11407 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

11424 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

11471 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

11532 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

11638 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

11661 Public Employee3 3/30/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

11665 Public Employee3 3/30/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

11683 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

11697 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

11716 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

11718 Public Employee & Pension/Retiree 6/10/2021

Department of Natural and Environmental Resources, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

11724 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

11737 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

11738 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

11768 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

11826 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

11834 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

11856 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 18 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

11869 Public Employee 5/4/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 11973 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

12012 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

12058 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

12091 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

12102 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

12114 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 12191 Public Employee & Pension/Retiree 7/29/2022 Department of Justice, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting response N N/A 

12251 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

12282 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 12297 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

12348 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

12370 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

12383 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

12399 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

12470 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

12483 Pension/Retiree 7/10/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

12500 Public Employee 12/20/2022 Administration of Correction Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 19 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

12534 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 12573 Public Employee & Union Grievance 7/29/2022 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 12598 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

12602 Public Employee 6/10/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

12605 Public Employee & 

Pension/Retiree2 5/4/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

12611 Public Employee & Pension/Retiree 6/10/2021 Department of Treasury, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 12675 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

12741 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

12761 Public Employee & Union Grievance 7/29/2022 Department of Correction and Rehabilitation Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

12772 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

12779 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

12851 Public Employee 5/4/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 12854 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 12860 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

12898 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

12941 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

12954 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

12956 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

12968 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 20 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

12977 Pension/Retiree 10/22/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

12978 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

12980 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

13022 Union Grievance 7/13/2021 Forensics Science Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

13044 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

13092 Public Employee 11/11/2020 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

13113 Public Employee 3/30/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

13130 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

13153 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

13195 Public Employee & Union Grievance 7/29/2022 Department of Family, Family and Children Administration Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

13229 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

13248 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

13309 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

13320 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

13339 Pension/Retiree 10/22/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

13368 Public Employee & Pension/Retiree 11/11/2020

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

13478 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

13484 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 21 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

13587 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

13592 Tax Refund 10/1/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

13670 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

13690 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

13740 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

13756 Public Employee & Pension/Retiree 10/22/2020 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

13784 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

13857 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

13877 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

13884 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

13940 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

13963 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

14022 Public Employee & Pension/Retiree 6/10/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 14069 Public Employee 5/4/2021 Child Support Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

14085 Public Employee & Union Grievance 6/10/2021 Vocational Rehabilitation Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

14088 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

14159 Pension/Retiree 11/6/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review7 

14175 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

14182 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 22 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

14230 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 14256 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

14300 Public Employee & 

Pension/Retiree2 5/4/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

14317 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

14340 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

14346 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

14366 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 14416 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

14463 Public Employee 11/11/2020 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

14482 Public Employee & Union Grievance 5/4/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 14504 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

14627 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

14695 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

14710 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

14730 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 14744 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

14762 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

14783 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 23 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

14823 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

14839 Pension/Retiree 11/13/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

14886 Public Employee3 6/10/2021 Department of Consumer Affairs Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

14947 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

14951 Public Employee, Pension/Retiree & Union Grievance 7/29/2022

Department of Family, Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

14977 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

15010 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

15149 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

15169 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

15203 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 15214 Public Employee & Pension/Retiree 11/11/2020

Corps of Medical Emergencies Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

15323 Public Employee & Pension/Retiree 6/10/2021

Corps of Medical Emergencies Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

15440 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

15457 Public Employee 12/20/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

15575 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

15713 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

15926 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

15948 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

16013 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 24 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

16128 Public Employee & Pension/Retiree 3/30/2021

Family and Children Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

16130 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

16149 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

16200 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

16253 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

16268 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

16319 Public Employee3 6/10/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

16321 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

16395

Union Grievance & Pension/Retiree5 7/13/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

16506 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

16551 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

16554 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

16595 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

16596 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

16642 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

16800 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

16857 Public Employee & Pension/Retiree 6/10/2021 Public Service Appellate Commission Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

16874 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

16875 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 25 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

16878 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

16898 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

16903 Public Employee & Pension/Retiree 10/22/2020 Department of Housing & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A Y Y N/A N N/A 

16960 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

17075 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

17078 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

17106 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

17139 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

17140 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

17190 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

17253 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review7 

17259 Public Employee 11/13/2020 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

17263 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

17348 Public Employee 5/4/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

17352 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

17498 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

17518 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

17528 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 26 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

17530 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

17548 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

17626 Public Employee3 6/10/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

17632 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

17635 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

17654 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

17655 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

17672 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

17710 Public Employee & Pension/Retiree 6/10/2021

Socioeconomic Development of the Family Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

17811 Public Employee 3/30/2021 Department of Justice Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

17812 Public Employee & 

Pension/Retiree2 5/4/2021 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

17907 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

17917 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

17919 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

17960 Public Employee3 6/10/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

17978 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

17990 Public Employee 7/29/2022 Department of Correction and Rehabilitation Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

17994 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

17996 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 27 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

18031 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 18042 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

18061 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

18123 Public Employee 12/20/2022 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 18135 Public Employee & 

Pension/Retiree4 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Puerto Rico Police Bureau

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

18143 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

18240 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

18303 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

18467 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

18471 Public Employee & Pension/Retiree 6/10/2021 Highway and Transportation Authority Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

18506 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

18545 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

18556 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

18807 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

18832 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

18839 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

18840 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Justice Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

18901 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 28 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

18962 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

18969 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

18975 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

18983 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

19002 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

19045 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

19066 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

19092 Public Employee 5/4/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 19113 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

19164 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

19178 Public Employee & 

Pension/Retiree2 5/4/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

19190 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

19252 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

19277 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

19353 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 19425 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

19433 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

19468 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 19504 Public Employee 6/10/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 29 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

19537 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

19548 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

19574 Public Employee 12/20/2022

Department of Family, Family and Children Administration, Vocational Rehabilitation Administration

Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

19601 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

19706 Public Employee & Pension/Retiree 10/22/2020

Department of Family, Family and Children Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

19734 Public Employee 12/20/2022 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 19772 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

19842 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

19863 Pension/Retiree 11/13/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

19870 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

19939 Public Employee 7/29/2022 Highway and Transportation Authority N/A N/A N/A N/A N/A N/A N/A 

19951 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

19990 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

20011 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

20028 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

20069 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

20071 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

20077 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

20083 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 30 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

20089 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

20108 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

20111 Public Employee & Union Grievance 7/29/2022 Highway and Transportation Authority Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

20133 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

20134 Public Employee & Union Grievance 7/29/2022 Highway and Transportation Authority Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

20141 Public Employee & Pension/Retiree 10/22/2020 Department of Housing & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A Y Y N/A N N/A 

20160 Public Employee 12/20/2022 PR Police Bureau, PR Police Department Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 20174 Public Employee & Pension/Retiree 10/22/2020 Child Support Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

20177 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

20178 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

20185 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

20188 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

20189 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

20192 Public Employee & 

Pension/Retiree2 5/4/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

20194 Public Employee & Union Grievance 7/29/2022 Highway and Transportation Authority Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

20217 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

20221 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

20223 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

20228 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 31 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

20288 Public Employee & 

Pension/Retiree2 11/11/2020 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

20322 Public Employee & Union Grievance 7/29/2022 Highway and Transportation Authority Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

20330 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

20394 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

20435 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

20442 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

20451 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

20465 Pension/Retiree 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

20495 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

20513 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

20568 Public Employee 11/13/2020 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

20581 Public Employee3 11/11/2020 Office of the OMBUDSMAN Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

20840 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

20841 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

20909 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

20982 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

21100 Public Employee & Pension/Retiree 10/22/2020

Department of Family, Socioeconomic

Development of the Family Administration & Employees Retirement System of the Government of the Commonwealth of Puerto 

Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

21204 Public Employee & 

Pension/Retiree2 5/4/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

21255 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 32 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

21257 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

21274 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

21351 Union Grievance 7/29/2022 Multiple Agencies Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

21390 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

21392 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

21393 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

21405 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

21525 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

21631 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

21674 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

21812 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

21875 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

21894 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

21920 Public Employee & Pension/Retiree 6/10/2021 Department of Justice Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

22025 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

22027 Pension/Retiree 10/22/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

22068 Public Employee 6/10/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

22090 Public Employee & Pension/Retiree 6/10/2021 Administration of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

22207 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 33 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

22274 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

22303 Public Employee 11/13/2020 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

22412 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

22422 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

22449 Public Employee & Pension/Retiree 10/22/2020 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

22473 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

22537 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

22590 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

22617 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

22655 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

22664 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

22668 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

22696 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

22719 Public Employee & 

Pension/Retiree4 1/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

22743 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

22855 Public Employee 3/30/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

22857 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

22866 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

22895 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 34 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

22936 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

23012 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

23025 Public Employee & Union Grievance 11/13/2020 Family and Children Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

23045 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

23162 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

23164 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

23198 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 23207 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

23271 Public Employee & Pension/Retiree 4/21/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

23425 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

23480 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

23544 Public Employee3 6/10/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

23553 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

23591 Public Employee & 

Pension/Retiree2 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

23668 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

23672 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

23743 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

23754 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

23800 Public Employee 5/4/2021 Department of Public Safety, Puerto Rico Medical Emergencies Corps Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 35 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

23903 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

23910 Pension/Retiree 11/13/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

23916 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

24058 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

24092 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

24123 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

24129 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

24131 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

24133 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

24200 Public Employee 5/4/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

24277 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

24365 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

24423 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

24547 Public Employee3 6/10/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

24550 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

24590 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

24655 Public Employee & 

Pension/Retiree2 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

24658 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

24726 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 36 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

24753 Public Employee 12/20/2022 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 24789 Public Employee 11/11/2020 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

24839 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

24889 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

24947 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

24960 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

25000 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

25107 Public Employee & Pension/Retiree 6/10/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 25158 Public Employee & Pension/Retiree 3/30/2021 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 25171 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 25220 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

25231 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

25343 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

25448 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 25467 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

25479 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

25573 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

25610 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

25651 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 37 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

25707 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

25715 Public Employee 5/4/2021 Department of Justice Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

25771 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

25926 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

25997 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

26010 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

26056 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

26078 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

26104 Public Employee 12/20/2022

Department of Family, Family and Children Administration, Vocational Rehabilitation Administration

Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

26112 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

26167 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

26179 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 26209 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

26284 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

26301 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

26330 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

26385 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

26403 Public Employee & Pension/Retiree 11/11/2020 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

26407 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 38 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

26431 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

26453 Pension/Retiree 11/6/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review7 

26555 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

26602 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

26608 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

26660 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

26690 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

26710 Public Employee 12/20/2022 Department of Family, Department of Correction & Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

26711 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

26740 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

26802 Pension/Retiree1 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

26957 Public Employee 6/10/2021 Department of Family, Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

27088 Public Employee & Pension/Retiree 6/10/2021 Family and Children Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

27161 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

27170 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

27180 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

27189 Public Employee & 

Pension/Retiree4 3/30/2021

Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

27266 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

27280 Public Employee & Pension/Retiree 11/13/2020 Family and Children Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 39 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

27349 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

27364 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

27376 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

27542 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

27604 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

27667 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

27676 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

27749 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

27764 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

27839 Public Employee 5/4/2021 Department of Justice Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

27852 Public Employee 5/4/2021 Department of Justice Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

27862 Public Employee & Union Grievance 11/13/2020 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

27872 Pension/Retiree 11/6/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

27922 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

28009 Pension/Retiree 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

28019 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

28083 Public Employee 11/13/2020 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

28124 Public Employee & Pension/Retiree 6/10/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 28160 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 40 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

28200 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 28211 Public Employee & 

Pension/Retiree4 11/11/2020

Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

28230 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

28278 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

28299 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

28342 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

28402 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

28413 Public Employee & 

Pension/Retiree4 3/30/2021

Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

28456 Public Employee & Union Grievance 7/29/2022 Department of Family, Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 28477 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

28496 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

28511 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

28538 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

28547 Public Employee & 

Pension/Retiree4 3/30/2021

Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

28557 Public Employee 5/4/2021 Department of Sports and Recreation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

28558 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

28587 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

28601 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

28632 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 41 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

28678 Public Employee & 

Pension/Retiree4 1/4/2021

Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

28690 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 28705 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

28708 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

28809 Pension/Retiree 8/25/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

28810 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

28814 Public Employee & Pension/Retiree 11/11/2020

Department of Natural and Environmental Resources & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

28835 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

28891 Public Employee, Pension/Retiree & Union Grievance 3/30/2021 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 28899 Pension/Retiree 7/29/2022

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

28939 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

28967 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

28976 Public Employee, Pension/Retiree & Union Grievance 6/10/2021

Department of Natural and Environmental Resources, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

28987 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

28991 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

29113 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

29177 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

29321 Public Employee & Union Grievance 11/13/2020 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

29324 Public Employee 5/4/2021 Department of Justice Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 42 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

29359 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

29407 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

29423 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

29468 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

29608 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

29639 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

29644 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

29676 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

29713 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

29715 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 29740 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

29760 Public Employee & Pension/Retiree 11/11/2020 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

29790 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

29808 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

29848 Public Employee & Pension/Retiree 11/11/2020

Department of Natural and Environmental Resources, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

29915 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

30020 Pension/Retiree 11/11/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

30033 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

30082 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 43 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

30093 Public Employee 12/20/2022 Department of Family, Department of Correction & Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

30129 Public Employee 12/20/2022 Department of Family, Department of Correction & Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

30132 Public Employee & Union Grievance 7/29/2022 Department of Family, Socioeconomic Development of the Family Administration Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting response N N/A 

30158 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

30236 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

30250 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

30254 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

30267 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review7 

30316 Public Employee & Union Grievance 7/29/2022 Mental Health Services and Addiction Control Administration Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

30319 Public Employee & Pension/Retiree 6/10/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

30528 Public Employee 3/30/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

30549 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

30576 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

30594 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

30654 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

30711 Public Employee & Union Grievance 7/29/2022 Department of Correction and Rehabilitation, Administration of Correction Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

30764 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

30790 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

30794 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 44 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

30836 Public Employee & 

Pension/Retiree4 3/30/2021

Puerto Rico Police Bureau, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

30853 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

30879 Public Employee & Pension/Retiree 6/10/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

30882 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

30883 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

30917 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

30927 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

30949 Public Employee 7/2/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

30990 Pension/Retiree 11/13/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

30999 Public Employee 12/20/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

31029 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

31036 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

31063 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

31090 Public Employee 5/4/2021 Public Service Appellate Commission Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

31130 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

31160 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

31215 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

31247 Public Employee 12/20/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 31274 Public Employee 5/4/2021 Administration of Youth Institutions, Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 45 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

31285 Public Employee 12/20/2022

Department of Family, Family and Children Administration, Vocational Rehabilitation Administration

Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

31349 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

31350 Public Employee 3/30/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 31379 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

31415 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

31422 Pension/Retiree 12/20/2022

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A N N/A 

31479 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 31581 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

31592 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

31640 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

31668 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

31708 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

31771 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

31861 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

31987 Public Employee & Pension/Retiree2 11/11/2020

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

32066 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

32119 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

32148 Public Employee & Pension/Retiree 10/22/2020 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

32186 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 46 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

32223 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

32283 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 32304 Public Employee 12/20/2022

Department of Family, Family and Children Administration, Vocational Rehabilitation Administration

Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

32323 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

32335 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

32347 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

32375 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

32382 Public Employee 12/20/2022

Department of Family, Family and Children Administration, Vocational Rehabilitation Administration

Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

32395 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

32404 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

32429 Public Employee & Pension/Retiree2 5/4/2021 Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

32461 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

32509 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

32553 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

32564 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

32598 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

32621 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

32642 Union Grievance 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

32718 Public Employee & Union Grievance 3/30/2021 Family and Children Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 47 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

32758 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

32812 Public Employee & Pension/Retiree 11/13/2020

Department of Natural and Environmental Resources & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

32813 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

32817 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

32881 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

32899 Public Employee & Pension/Retiree 6/10/2021

Socioeconomic Development of the Family Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

32912 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

33010 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

33060 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

33085 Union Grievance 8/25/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 33096 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

33127 Public Employee & Pension/Retiree 6/10/2021 Public Building Authority Y N/A Y Y N/A N N/A 33141 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

33144 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

33200 Public Employee 5/4/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 33230 Public Employee & Pension/Retiree 11/11/2020

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

33246 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

33313 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

33364 Public Employee & Pension/Retiree 11/11/2020 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 48 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

33393 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

33396 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

33431 Public Employee3 7/13/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

33472 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 33513 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

33535 Public Employee & Union Grievance 6/10/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 33637 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

33642 Union Grievance 5/4/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 33663 Public Employee 12/20/2022 Department of Family Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 33710 Public Employee & 

Pension/Retiree2 5/4/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

33784 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

33793 Public Employee & Union Grievance 7/29/2022 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

33810 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

33846 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

33856 Public Employee & Union Grievance 7/29/2022 Mental Health Services and Addiction Control Administration Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

33873 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

33921 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

33957 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

34028 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 49 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

34048 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

34123 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

34134 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

34156 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

34189 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

34197 Public Employee 3/30/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

34205 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 34221 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

34224 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

34235 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

34238 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

34246 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

34296 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

34325 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

34326 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

34408 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

34410 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

34441 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

34451 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 50 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

34477 Public Employee & Pension/Retiree 3/30/2021

Department of Transportation and Public Works & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

34541 Union Grievance 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

34558 Public Employee3 6/10/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

34560 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

34564 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

34566 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

34569 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

34626 Public Employee & 

Pension/Retiree2 6/10/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

34628 Public Employee & Pension/Retiree 6/10/2021

Highway and Transportation Authority & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

34673 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

34700 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

34734 Public Employee & Pension/Retiree 6/10/2021 Administration of Correction Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

34771 Public Employee & Pension/Retiree 10/22/2020

Department of Natural and Environmental Resources, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

34819 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

34864 Public Employee 11/11/2020 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

34911 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

34944 Public Employee, Pension/Retiree & Union Grievance 6/10/2021

Department of Natural and Environmental Resources and Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

34978 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

34980 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 51 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

34994 Public Employee 12/20/2022 Department of Family Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 34995 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

35024 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

35041 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

35226 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

35234 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

35235 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 35250 Public Employee & Pension/Retiree 6/10/2021 Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 35361 Public Employee 11/11/2020 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

35377 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 35393 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

35422 Public Employee & Union Grievance 7/29/2022 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 35515 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

35532 Public Employee 5/4/2021 Department of Family, Department of Social Services Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 35544 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

35551 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

35552 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

35605 Public Employee & Pension/Retiree 11/11/2020 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

35656 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 52 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

35664 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

35709 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

35715 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

35782 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

35840 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

35842 Public Employee & Pension/Retiree2 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 35851 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

35898 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

35904 Public Employee 12/20/2022 Administration of Vocational Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

35917 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

35931 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

35940 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

35949 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

35978 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 35982 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

36029 Public Employee & Pension/Retiree 3/30/2021

Socioeconomic Development of the Family Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

36037 Public Employee 11/11/2020 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

36092 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

36137 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 53 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

36149 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

36186 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

36220 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

36226 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

36329 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

36387 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

36494 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

36578 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

36622 Public Employee & Pension/Retiree 6/10/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

36642 Public Employee & Pension/Retiree 10/22/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

36663 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

36674 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 36718 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

36765 Union Grievance 11/13/2020 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

36775 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

36787 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 36813 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

36837 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

36843 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 54 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

36847 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

36875 Public Employee 12/20/2022

Department of Family, Family and Children Administration, Vocational Rehabilitation Administration

Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

36931 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

37002 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

37017 Public Employee & Union Grievance 11/11/2020 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

37091 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

37128 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

37159 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 37226 Public Employee & Union Grievance 7/29/2022 Department of Family, Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 37263 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

37286 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

37305 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

37308 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

37316 Public Employee 12/20/2022

Department of Family, Family and Children Administration, Vocational Rehabilitation Administration

Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

37364 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

37377 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

37382 Public Employee & 

Pension/Retiree2 5/4/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

37456 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

37542 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 55 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

37602 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

37694 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

37704 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

37740 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

37749 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

37762 Public Employee & Union Grievance 7/29/2022 Highway and Transportation Authority Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

37786 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

37787 Public Employee 1/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

37792 Public Employee & 

Pension/Retiree4 9/8/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

37806 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

37807 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

37815 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

37859 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

37897 Union Grievance 7/13/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

37945 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

37956 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

38002 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

38090 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

38140 Public Employee 3/30/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 56 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

38154 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

38203 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

38221 Public Employee & Pension/Retiree 6/10/2021 Highway and Transportation Authority Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

38230 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

38234 Public Employee 12/20/2022 Department of Family Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

38236 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

38254 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

38261 Public Employee3 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

38321 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

38346 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

38379 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

38401 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

38429 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

38435 Public Employee & 

Pension/Retiree2 5/4/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

38442 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

38458 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

38475 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

38579 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

38612 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 57 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

38647 Public Employee & Pension/Retiree2 5/4/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 38676 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

38691 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

38757 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

38758 Public Employee 6/10/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

38763 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

38861 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

38871 Public Employee & Union Grievance 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

38892 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

38900 Public Employee & Pension/Retiree 6/10/2021 Department of Health, AFASS - Hospital Regional - Caguas Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 38943 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 38969 Public Employee & Union Grievance 7/29/2022 Highway and Transportation Authority Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

38979 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

39009 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

39060 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

39134 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto 

Rico

Y N/A Y Y N/A Y In Process/Under Review 

39136 Public Employee 5/4/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

39191 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

39259 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 58 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

39299 Public Employee & Union Grievance 11/13/2020 Family and Children Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

39314 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

39318 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 39338 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 39347 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

39365 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

39373 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

39387 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

39436 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

39451 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

39468 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

39486 Public Employee & Union Grievance 7/29/2022 Highway and Transportation Authority Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

39518 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

39643 Public Employee3 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

39656 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

39675 Public Employee3 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

39760 Public Employee 5/4/2021 Administration of Labor Rights, Department of Work and Human Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 39780 Public Employee 6/10/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

39804 Pension/Retiree 10/22/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 59 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

39865 Public Employee & Pension/Retiree 6/10/2021 Department of Economic Development and Commerce Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 39871 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

39938 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

39977 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

39995 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

40052 Public Employee & Union Grievance 7/29/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

40116 Public Employee 5/4/2021 Department of Agriculture Y N/A Y Y N/A N N/A 40272 Public Employee & Pension/Retiree 6/10/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 40285 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

40317 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

40330 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 40332 Public Employee & Union Grievance 3/30/2021 Family and Children Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

40394 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

40423 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

40453 Public Employee 3/30/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

40497 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

40502 Public Employee & Union Grievance 7/29/2022 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 40589 Public Employee & Union Grievance 7/29/2022 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

40591 Public Employee & 

Pension/Retiree2 11/11/2020

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 60 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

40597 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

40612 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

40616 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

40648 Public Employee & Pension/Retiree 11/13/2020

Socioeconomic Development of the Family Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

40654 Public Employee 5/4/2021 Office of Court Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

40686 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

40694 Public Employee3 6/10/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

40708 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

40771 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

40778 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

40814 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 40823 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

40831 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

40852 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

40865 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

40873 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 40882 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

40907 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 61 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

40960 Public Employee 12/20/2022 Department of Family Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 40969 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

40979 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

41005 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

41008 Public Employee 6/10/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

41064 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 41089 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

41154 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

41245 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

41266 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

41292 Public Employee 7/29/2022 Department of Agriculture Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

41393 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

41458 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

41498 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 41519 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

41543 Public Employee 5/4/2021 Administration of the Right to Work, Department of Work Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 41564 Public Employee & Pension/Retiree 11/13/2020

Vocational Rehabilitation Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A N N/A 

41568 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

41605 Public Employee & Pension/Retiree 10/22/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 62 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

41610 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

41626 Pension/Retiree 11/11/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

41658 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

41666 Public Employee3 6/10/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

41676 Public Employee & Pension/Retiree 5/4/2021 Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 41687 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 41710 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 41788 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

41816 Public Employee 5/4/2021 Administration of Correction Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

41878 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 41893 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

41942 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

41943 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

41966 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

41972 Public Employee 7/13/2021 Department of Education, Department of Treasury Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 42007 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

42045 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

42073 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

42126 Public Employee 6/10/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 63 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

42139 Public Employee 11/11/2020 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

42167 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

42190 Public Employee & Union Grievance 11/13/2020 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

42196 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

42208 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

42209 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

42248 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

42280 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 42290 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

42304 Public Employee & Pension/Retiree 6/10/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 42324 Public Employee3 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

42375 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 42391 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

42430 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

42433 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

42434 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

42445 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 42457 Union Grievance 7/13/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 42503 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 64 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

42515 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

42548 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

42587 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

42607 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

42690 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

42773 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

42835 Public Employee 12/20/2022 PR Police Bureau, PR Police Department Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 42855 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Department of Treasury Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

42863 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

42877 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

42909 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

42923 Public Employee 12/20/2022 Department of Family, Department of Correction & Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

42963 Public Employee, Pension/Retiree & Union Grievance 7/29/2022 Department of Housing Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

43073 Public Employee 12/20/2022 PR Police Bureau, PR Police Department Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 43082 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

43085 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

43147 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

43150 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto 

Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 65 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

43192 Public Employee 12/20/2022

Department of Family, Family and Children Administration, Vocational Rehabilitation Administration

Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

43217 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 43218 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

43231 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 43253 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

43257 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

43262 Public Employee & Pension/Retiree 8/25/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

43266 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

43290 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

43323 Pension/Retiree 7/29/2022

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A N N/A 

43333 Public Employee & Pension/Retiree 6/10/2021 Institute of Forensic Science Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

43360 Public Employee & Pension/Retiree 11/11/2020 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

43363 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

43383 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

43390 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

43432 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

43483 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

43492 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

43500 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 66 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

43526 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

43537 Public Employee 3/30/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

43545 Public Employee 7/2/2021

Administration of the Government Retirement Systems and the Judiciary, Department of Education

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

43555 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

43571 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

43603 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

43612 Public Employee & 

Pension/Retiree2 10/22/2020 Office of Court Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

43613 Public Employee & 

Pension/Retiree2 5/4/2021

Corps of Firefighters Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

43627 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

43630 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

43672 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

43679 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

43703 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

43711 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

43736 Public Employee & Pension/Retiree 6/10/2021

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

43834 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

43867 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

43868 Public Employee3 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 67 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

44005 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

44016 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

44028 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

44053 Public Employee & Pension/Retiree 11/13/2020

Department of Correction and Rehabilitation & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

44062 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

44124 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

44131 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

44134 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 44191 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 44205 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

44212 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

44213 Public Employee & 

Pension/Retiree2 5/4/2021 Administration of the Government Retirement Systems and the Judiciary Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

44267 Public Employee & 

Pension/Retiree2 11/11/2020

Department of Natural and Environmental Resources, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

44269 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 44313 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

44368 Public Employee & Pension/Retiree 10/22/2020 Department of Treasury Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

44376 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

44419 Public Employee & Pension/Retiree 10/22/2020 Department of Justice & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

44423 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 68 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

44432 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

44528 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

44547 Public Employee & Pension/Retiree 10/22/2020

Socioeconomic Development of the Family Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

44594 Public Employee & Pension/Retiree 3/30/2021

Socioeconomic Development of the Family Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

44620 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

44624 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

44632 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 44663 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

44714 Public Employee 1/4/2021 Department of Family, Family and Children Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 44720 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

44782 Public Employee & Pension/Retiree 10/22/2020 Department of Treasury & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

44838 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

44940 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 44956 Public Employee & Pension/Retiree 7/13/2021 Puerto Rico Education Council, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 44997 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

45042 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

45043 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

45069 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

45076 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 69 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

45094 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

45095 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

45138 Public Employee 5/4/2021 Department of Justice Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

45156 Public Employee & 

Pension/Retiree2 10/22/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

45158 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

45163 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

45179 Public Employee & Pension/Retiree 3/30/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 45224 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

45254 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

45280 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

45285 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

45293 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

45301 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

45331 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 45344 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 45383 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

45399 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 45409 Public Employee 6/10/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 45428 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 70 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

45432 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

45466 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

45495 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

45535 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

45540 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

45541 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

45542 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

45574 Public Employee 10/22/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

45577 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

45616 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

45708 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

45761 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

45786 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

45787 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

45809 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

45811 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

45931 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 45934 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

45946 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 71 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

45995 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

46015 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

46047 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

46074 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

46108 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 46137 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

46187 Public Employee 3/30/2021 Driver Services Center, Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 46269 Public Employee3 6/10/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

46298 Public Employee 3/30/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

46340 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

46344 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

46355 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

46367 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

46369 Public Employee & Pension/Retiree 6/10/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 46380 Public Employee 1/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

46496 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

46497 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

46526 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

46527 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 72 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

46587 Public Employee & Pension/Retiree 6/10/2021 Department of Sports and Recreation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

46606 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 46660 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

46678 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

46685 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

46700 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

46701 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

46708 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

46737 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

46741 Public Employee & Pension/Retiree 3/30/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 46743 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

46855 Public Employee & 

Pension/Retiree4 1/4/2021

Office of Court Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

46963 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Department of Labor and Human Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

46988 Public Employee 7/29/2022 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 47000 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

47048 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

47085 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

47110 Union Grievance 7/13/2021 Child Support Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

47150 Public Employee & Union Grievance 7/29/2022 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 73 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

47166 Public Employee 5/4/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 47235 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

47259 Public Employee & Union Grievance 7/29/2022 Department of Natural and Environmental Resources Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

47314 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

47315 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

47358 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 47369 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

47405 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

47524 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

47547 Union Grievance 7/13/2021 Administration of the Government Retirement Systems and the Judiciary Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

47646 Pension/Retiree 9/8/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

47657 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

47699 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

47719 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

47800 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

47838 Public Employee & Pension/Retiree 6/10/2021 Department of Justice Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

47865 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

47889 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 74 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

47948 Pension/Retiree1 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

47951 Public Employee 12/20/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

48117 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

48141 Pension/Retiree 11/11/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

48169 Public Employee & Pension/Retiree 6/10/2021 Department of Public Safety, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 48187 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

48201 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

48229 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 48230 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

48235 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

48302 Public Employee & Pension/Retiree 3/30/2021 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 48349 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

48371 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

48396 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

48490 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

48502 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

48523 Pension/Retiree 1/4/2021

Employees Retirement System of the 

Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

48526 Public Employee 3/30/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 75 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

48531 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 48544 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

48595 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 48617 Pension/Retiree 11/11/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

48629 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

48640 Public Employee 3/30/2021 Department of Court, Department of Justice Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

48648 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

48694 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

48725 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

48738 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

48742 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

48750 Public Employee & Union Grievance 3/30/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 48786 Public Employee3 6/10/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

48802 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

48803 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

48847 Public Employee & Pension/Retiree 3/30/2021 Department of Treasury Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

48863 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

48907 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

48932 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 76 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

48989 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49025 Public Employee 6/10/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 49028 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

49036 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49065 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49088 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 49113 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

49133 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49160 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49167 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

49184 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

49214 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49244 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 49253 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49271 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

49291 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49299 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49308 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 49339 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 77 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

49344 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 49347 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 49358 Public Employee3 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49422 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 49468 Public Employee 12/20/2022 Department of Family, Department of Correction & Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

49470 Pension/Retiree 10/22/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

49483 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49510 Public Employee & Pension/Retiree 11/11/2020 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

49590 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

49592 Public Employee3 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49673 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49675 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

49682 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

49702 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

49760 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49769 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49789 Pension/Retiree 11/6/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

49797 Public Employee & 

Pension/Retiree2 11/13/2020 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49805 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 78 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

49830 Public Employee & Union Grievance 6/10/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 49869 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49931 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

49937 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49942 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

49943 Public Employee & Pension/Retiree 11/11/2020

Vocational Rehabilitation Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A N N/A 

49968 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

49977 Public Employee & Pension/Retiree 7/13/2021 Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

49984 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 50052 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

50054 Public Employee 5/4/2021 Department of Housing Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50060 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50070 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50076 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

50093 Public Employee 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 50124 Public Employee3 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50126 Public Employee & Pension/Retiree 10/22/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

50162 Public Employee & Pension/Retiree 6/10/2021 Department of Public Safety, Puerto Rico Police Bureau Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

50176 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 79 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

50178 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

50179 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 50183 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

50189 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

50198 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50218 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 50224 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 50261 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 50315 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50324 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

50351 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

50373 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

50403 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50408 Public Employee 7/2/2021 Department of Education N

Claimant did not provide an 

address for request letters to 

be sent12

N N

Claimant did not provide an 

address for request letters to be 

sent

N N/A 

50457 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50460 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50470 Public Employee & Pension/Retiree 10/22/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

50481 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50502 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 80 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

50513 Public Employee & Pension/Retiree 10/22/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

50530 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50545 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

50561 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 50563 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

50573 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

50584 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 50604 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50635 Public Employee & Pension/Retiree 10/22/2020 Public Housing Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A Y Y N/A N N/A 

50658 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50675 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

50710 Public Employee & Pension/Retiree 10/22/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

50719 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50752 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 50757 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

50767 Public Employee & Pension/Retiree2 10/22/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

50768 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

50786 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

50797 Public Employee 5/4/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 81 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

50798 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50802 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50838 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50848 Public Employee 11/11/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50863 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

50872 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

50880 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

50905 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 50909 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50914 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50918 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

50919 Public Employee & Pension/Retiree 11/11/2020 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

50927 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 50935 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 50938 Public Employee & Pension/Retiree 3/30/2021 Department of Labor and Human Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

50975 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

50982 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

50987 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50995 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 82 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

50998 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51011 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 51022 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

51061 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 51062 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 51064 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

51072 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

51118 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51119 Public Employee & Pension/Retiree 7/29/2022 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting response N N/A 

51135 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51148 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51155 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

51157 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

51224 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

51264 Public Employee & 

Pension/Retiree2 11/11/2020

Public Housing Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51279 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51314 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51331 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51351 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 83 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

51358 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51370 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

51375 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51408 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

51409 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51412 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51419 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 51495 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51500 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

51530 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

51587 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

51593 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 51596 Pension/Retiree1 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

51604 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51608 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

51614 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

51635 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51651 Public Employee & Pension/Retiree 6/10/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 84 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

51657 Public Employee & 

Pension/Retiree2 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

51662 Public Employee 5/4/2021 Office of Court Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51663 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 51678 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 51690 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

51705 Public Employee & Pension/Retiree 1/4/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

51772 Public Employee 5/4/2021 Office of Court Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51782 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51800 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51806 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51823 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

51828 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

51843 Public Employee & Pension/Retiree 6/10/2021

Mental Health Services and Addiction Control Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51886 Public Employee & Pension/Retiree 6/10/2021 Department of Public Safety, Puerto Rico Police Bureau Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

51891 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51892 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51907 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

51909 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51947 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 85 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

51964 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51982 Public Employee & Pension/Retiree 10/22/2020 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

51983 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 52007 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

52012 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

52017 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

52018 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

52031 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

52041 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

52064 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

52115 Public Employee & Union Grievance 3/30/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

52119 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

52184 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 52191 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

52233 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

52236 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

52283 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

52284 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

52294 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 86 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

52326 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

52331 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 52361 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

52366 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 52392 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 52438 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 52452 Pension/Retiree 10/22/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

52465 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

52535 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

52541 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

52606 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

52637 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

52706 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 52746 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

52808 Pension/Retiree1 10/22/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

52840 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

52858 Public Employee & 

Pension/Retiree2 11/11/2020

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

52921 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 52932 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 87 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

52943 Public Employee & Pension/Retiree 6/10/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

52970 Public Employee & 

Pension/Retiree2 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

52997 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

53000 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 53027 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

53052 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 53072 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

53074 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 53079 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

53083 Public Employee & 

Pension/Retiree2 10/22/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

53134 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

53154 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

53162 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

53178 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 53202 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

53204 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 53237 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

53267 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

53284 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 88 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

53303 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

53310 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

53324 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 53331 Public Employee 6/10/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

53344 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 53348 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

53383 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 53385 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 53425 Public Employee & Pension/Retiree 3/30/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 53456 Public Employee & Pension/Retiree 10/22/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

53495 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

53533 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

53569 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

53615 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

53616 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 53711 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 53714 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

53717 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

53743 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 89 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

53748 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

53760 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

53768 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

53809 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 53827 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 53854 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

53894 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

53922 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

53930 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 53972 Public Employee & 

Pension/Retiree4 1/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

53984 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54008 Public Employee & Pension/Retiree 6/10/2021

Department of Labor and Human Resources & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54024 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

54041 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

54045 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 54073 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

54091 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54112 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 54121 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 90 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

54122 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 54142 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54154 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

54179 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

54181 Public Employee & 

Pension/Retiree2 11/11/2020

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54197 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54234 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

54238 Public Employee3 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54241 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54379 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54389 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54401 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54475 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54518 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

54539 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

54546 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 54552 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

54589 Public Employee & 

Pension/Retiree2 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54612 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 91 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

54613 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54617 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 54625 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 54644 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 54654 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 54675 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54700 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

54706 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 54719 Public Employee 5/4/2021 Hospital Sequadria Forence, Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 54736 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54750 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54760 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

54806 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

54809 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

54854 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 54874 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

54895 Public Employee, Pension/Retiree & Union Grievance 11/11/2020

Department of Family, Family and Children Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54919 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 92 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

54923 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54940 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54982 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

55013 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 55073 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 55080 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

55084 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

55103 Public Employee 3/30/2021 Administration of Health Facilities and Services, Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 55124 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

55160 Public Employee & Pension/Retiree 6/10/2021 Department of Security and Public Protection Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

55188 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

55252 Public Employee3 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

55259 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 55263 Pension/Retiree 11/6/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review8 

55265 Public Employee & Pension/Retiree 7/2/2021 Department of Housing & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 55347 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

55365 Public Employee & 

Pension/Retiree2 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

55386 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

55413 Public Employee & Pension/Retiree2 10/22/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 93 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

55459 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

55469 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

55484 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 55499 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

55500 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

55502 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

55546 Public Employee3 6/10/2021 Hospital Sequadria Forence, Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

55568 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 55581 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

55599 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

55609 Public Employee & Union Grievance 11/13/2020 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

55653 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

55661 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

55673 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

55691 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

55701 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 55705 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 55728 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 94 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

55729 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

55738 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 55750 Public Employee & Pension/Retiree 10/22/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

55767 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

55784 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

55797 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

55811 Public Employee & 

Pension/Retiree2 10/22/2020

Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

55816 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

55817 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

55869 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 55880 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

55890 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

55928 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

55933 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

55978 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

56001 Public Employee & Pension/Retiree 3/30/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 56032 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

56039 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

56056 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 95 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

56057 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 56060 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

56078 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 56081 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

56108 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

56200 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

56204 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

56212 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

56258 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

56274 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

56306 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 56318 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 56327 Public Employee3 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

56339 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

56341 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

56371 Public Employee & Pension/Retiree 6/10/2021 Office of Court Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

56405 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

56475 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

56482 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 96 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

56486 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

56492 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

56534 Public Employee & Pension/Retiree2 10/22/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

56538 Public Employee 11/13/2020 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 56633 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

56660 Public Employee & Pension/Retiree 6/10/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

56676 Public Employee & Pension/Retiree 3/30/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 56677 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 56682 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

56687 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

56690 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

56725 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

56742 Pension/Retiree1 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

56764 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

56769 Public Employee3 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

56773 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

56791 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

56821 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

56846 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 97 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

56875 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 56949 Public Employee 3/30/2021 Administration of Health Facilities and Services, Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 56990 Public Employee3 6/10/2021 Hospital Sequadria Forence, Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

57027 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

57044 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

57068 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 57077 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

57150 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

57160 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

57163 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

57169 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 57182 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

57224 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

57243 Public Employee & Pension/Retiree 10/22/2020 Department of Health & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

57279 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

57289 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

57299 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

57309 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 98 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

57318 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

57401 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

57404 Public Employee3 6/10/2021 Department of Family (Cabo Rojo, PR local office - Region Mayaguez) Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

57445 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

57477 Public Employee & Pension/Retiree 10/22/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

57537 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

57541 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

57556 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

57572 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

57606 Public Employee 6/10/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

57613 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

57624 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

57666 Public Employee & Pension/Retiree 6/10/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 57682 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

57702 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

57713 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

57716 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

57735 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

57741 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 99 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

57796 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

57800 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

57808 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

57823 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

57833 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

57860 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

57889 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

57893 Public Employee & Pension/Retiree 6/10/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

57899 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

57903 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

57908 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

57949 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

58016 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

58024 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

58048 Public Employee & Pension/Retiree 6/10/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 58071 Public Employee & 

Pension/Retiree2 10/22/2020

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

58072 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

58094 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 100 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

58109 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

58120 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

58126 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

58196 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

58209 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

58238 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

58252 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

58259 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

58340 Union Grievance 7/13/2021 Administration of the Government Retirement Systems and the Judiciary Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

58355 Public Employee & Pension/Retiree 3/30/2021 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

58399 Public Employee & Pension/Retiree 6/10/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

58427 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

58439 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

58479 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

58487 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

58492 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

58497 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 58518 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Housing Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

58523 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 101 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

58529 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 58540 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

58542 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 58566 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Department of Family (Ponce Region) Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

58604 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

58607 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

58622 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

58625 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

58651 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 58673 Public Employee & Pension/Retiree 10/22/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

58685 Public Employee & Pension/Retiree 7/13/2021

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

58694 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

58753 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

58761 Public Employee 12/20/2022 PR Police Bureau, PR Police Department Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 58770 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

58795 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

58797 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

58888 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

58895 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 102 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

58952 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 58956 Public Employee 10/22/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 58995 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

59009 Public Employee & Pension/Retiree2 7/13/2021 Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 59020 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

59030 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

59046 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 59074 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

59114 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

59132 Public Employee & Pension/Retiree 10/22/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

59134 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 59162 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

59176 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

59212 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

59229 Public Employee & Pension/Retiree 6/10/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 59246 Public Employee & Pension/Retiree 11/11/2020 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

59258 Public Employee & Pension/Retiree 3/30/2021

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

59274 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

59289 Public Employee 3/30/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 103 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

59312 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

59319 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

59390 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 59430 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 59455 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

59465 Public Employee & 

Pension/Retiree4 1/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

59469 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

59526 Public Employee3 11/11/2020 Office of Court Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

59570 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

59573 Public Employee & Pension/Retiree2 10/22/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

59576 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

59592 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

59613 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

59637 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

59666 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

59678 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

59684 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

59687 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

59702 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 104 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

59725 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

59755 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

59761 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 59779 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

59800 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

59811 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

59847 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

59858 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

59859 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

59866 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 59868 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 59888 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

59923 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

59935 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

59936 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 59960 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

59985 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

59988 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 105 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

60003 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

60005 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

60077 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

60087 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 60101 Public Employee & Pension/Retiree 6/10/2021 Department of Labor and Human Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

60110 Public Employee3 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

60139 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

60221 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

60223 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

60233 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 60256 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

60278 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 60289 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

60320 Public Employee 12/20/2022 Department of Family, Department of Correction & Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

60463 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

60464 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 60468 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 60479 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

60481 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 106 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

60490 Public Employee3 11/11/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

60500 Public Employee 3/30/2021 Department of Family, Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 60524 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

60535 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

60566 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 60662 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 60692 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

60715 Public Employee & Pension/Retiree 10/22/2020 Public Housing Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A Y Y N/A N N/A 

60806 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

60809 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

60851 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

60863 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

60882 Public Employee 11/11/2020 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 60905 Public Employee & Union Grievance 7/29/2022 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

60954 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

60978 Public Employee & Pension/Retiree 6/10/2021

Family and Children Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

60980 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

61011 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

61065 Pension/Retiree 10/22/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 107 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

61154 Public Employee 12/20/2022 Department of Family, Department of Correction & Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

61181 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 61222 Public Employee & Union Grievance 11/13/2020 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

61279 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

61286 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

61318 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 61334 Public Employee & 

Pension/Retiree2 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

61340 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

61344 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

61347 Public Employee & Pension/Retiree 11/13/2020

Department of Family, Family and Children Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

61398 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 61406 Public Employee & 

Pension/Retiree2 10/22/2020

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

61425 Union Grievance 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

61437 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

61451 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

61508 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

61555 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

61561 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

61571 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 108 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

61598 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 61608 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

61621 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

61682 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 61701 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 61720 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 61729 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

61744 Public Employee & Pension/Retiree 1/4/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

61753 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

61815 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 61860 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

61899 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

61903 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

61910 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

61914 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

61923 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

61934 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

61935 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 61949 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 109 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

62024 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

62025 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

62048 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 62063 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

62094 Pension/Retiree 12/20/2022

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A N N/A 

62125 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

62179 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

62199 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

62223 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

62225 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

62229 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

62238 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

62239 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

62269 Public Employee 10/22/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 62306 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

62311 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

62340 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

62344 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

62420 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 110 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

62461 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 62466 Public Employee 10/22/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 62471 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

62474 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

62490 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

62493 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

62501 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

62517 Public Employee & Pension/Retiree 10/22/2020 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

62526 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

62527 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

62588 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 62598 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 62604 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 62659 Public Employee & Pension/Retiree 10/22/2020 Department of Health & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

62687 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 62727 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 62816 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

62840 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

62842 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 111 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

62870 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 62885 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

62912 Public Employee 6/10/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 62929 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 62982 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 63008 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

63013 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

63025 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

63030 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 63040 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

63047 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

63080 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

63114 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

63165 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 63187 Public Employee 7/29/2022 Highway and Transportation Authority Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

63205 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

63208 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 63211 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System, Institute of Puerto Rican Culture Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 63266 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 112 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

63273 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

63308 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

63350 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

63408 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 63411 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

63415 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

63449 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 63513 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

63570 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 63578 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

63612 Public Employee & Pension/Retiree 6/10/2021 Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

63615 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

63644 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

63647 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 63649 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

63656 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

63673 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

63677 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 63691 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 113 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

63731 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

63742 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

63749 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

63769 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 63813 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

63817 Public Employee, Pension/Retiree & Union Grievance 10/22/2020 Department of Health & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

63822 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 63826 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

63832 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

63850 Public Employee & 

Pension/Retiree2 5/4/2021 National Guard of Puerto Rico Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

63867 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

63868 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

63876 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

63883 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 63895 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

63899 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

63914 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

63931 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

63939 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 114 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

63977 Public Employee & Union Grievance 6/24/2022 Department of Justice, Office of Court Administration Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

63987 Public Employee & Pension/Retiree 10/22/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

64014 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

64049 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 64088 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

64099 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 64103 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

64192 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

64201 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

64240 Public Employee 12/20/2022 Department of Treasury Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

64314 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

64318 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

64344 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 64391 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

64421 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

64424 Public Employee 11/13/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

64443 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 64484 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 64496 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 115 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

64547 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

64548 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

64549 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

64569 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

64607 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

64611 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

64634 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

64705 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 64719 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

64752 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

64840 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

64848 Public Employee & Pension/Retiree2 5/4/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 64850 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

64869 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

64882 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

64891 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

64950 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

65081 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 65102 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 116 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

65110 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 65140 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

65163 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 65177 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

65201 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

65214 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

65227 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 65313 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

65365 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

65370 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

65374 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

65397 Public Employee 7/29/2022 Department of Justice Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

65415 Public Employee & Pension/Retiree 10/22/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

65418 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

65420 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

65507 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

65673 Public Employee & 

Pension/Retiree2 3/30/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

65678 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 65721 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 117 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

65724 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

65743 Public Employee 3/30/2021 National Guard of Puerto Rico Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

65751 Public Employee 5/4/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 65796 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

65798 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 65829 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

65910 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

65941 Union Grievance 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

65954 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

65961 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

66020 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

66045 Public Employee & Pension/Retiree 11/11/2020

Department of Correction and Rehabilitation & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

66054 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

66065 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

66203 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

66204 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

66230 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 66248 Public Employee 7/2/2021 Department of Education N

Claimant did not provide an 

address for request letters to 

be sent12

N N

Claimant did not provide an 

address for request letters to be 

sent

N N/A 

66252 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 118 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

66286 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

66300 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

66362 Public Employee & Pension/Retiree 3/30/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

66404 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 66441 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 66537 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 66560 Public Employee 6/10/2021 National Parks of Puerto Rico Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

66611 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

66662 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

66688 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

66782 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 66826 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

66841 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

66847 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

66861 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

66863 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

66873 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

66891 Pension/Retiree 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 119 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

66894 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Social Services Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

66907 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

66939 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

66989 Public Employee 6/10/2021 Department of Health, Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 67036 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

67039 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

67073 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

67100 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

67112 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

67130 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

67197 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

67257 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

67272 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

67286 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

67302 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

67366 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

67374 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 67377 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 67392 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 120 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

67399 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

67433 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 67449 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

67471 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

67523 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 67538 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

67567 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

67570 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 67614 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

67638 Public Employee & Union Grievance 10/22/2020 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

67639 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 67644 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

67683 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

67717 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

67776 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

67802 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

67823 Public Employee & 

Pension/Retiree2 11/11/2020 Department of Education, National Guard of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

67824 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

67886 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 121 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

67887 Public Employee & Pension/Retiree 3/30/2021

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

67910 Public Employee 11/11/2020 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

67912 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

67953 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

68006 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

68020 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

68028 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 68030 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

68146 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

68147 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

68160 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

68163 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

68179 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 68188 Public Employee & 

Pension/Retiree2 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

68189 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

68248 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

68254 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

68261 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

68305 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 122 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

68336 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

68343 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

68365 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 68440 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 68450 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

68458 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 68486 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

68515 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 68540 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 68552 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

68594 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

68608 Public Employee & Pension/Retiree 10/22/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

68619 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

68620 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

68626 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

68679 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

68702 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

68722 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

68770 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 123 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

68772 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

68776 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

68865 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

68920 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

68938 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

68939 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 69008 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 69031 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 69037 Public Employee & Pension/Retiree2 11/11/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

69047 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

69068 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 69078 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 69079 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

69082 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

69098 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

69110 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

69188 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

69199 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

69200 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 124 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

69210 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

69236 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

69241 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

69292 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

69306 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 69332 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 69349 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

69372 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

69409 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

69410 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

69473 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

69516 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

69636 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

69645 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 69689 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 69692 Pension/Retiree 11/6/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review7 

69820 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

69822 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

69858 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 125 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

69866 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

69870 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 69888 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

69892 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

69913 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 69936 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

69949 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

70002 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70090 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 70124 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70147 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

70159 Public Employee 11/11/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70163 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70166 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

70239 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70266 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

70275 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

70318 Public Employee 3/30/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 70362 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 126 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

70426 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 70429 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

70466 Public Employee & Pension/Retiree 6/10/2021 Department of Justice Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

70487 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70491 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70502 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70582 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70594 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 70615 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70625 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70652 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70657 Public Employee3 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70660 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

70667 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70731 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70740 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 70749 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70793 Public Employee & 

Pension/Retiree2 1/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70850 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 127 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

70860 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

70861 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70885 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70903 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 71006 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71056 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71057 Public Employee & Pension/Retiree 11/11/2020 Office of Court Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

71072 Public Employee3 11/11/2020 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71103 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 71129 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71136 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 71149 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71192 Public Employee & Union Grievance 7/29/2022 Department of Correction and Rehabilitation Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

71194 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 71257 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

71297 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

71316 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71369 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71408 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 128 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

71410 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71427 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

71441 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

71511 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

71520 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71535 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 71548 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 71562 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71571 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

71590 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71609 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71626 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71629 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71678 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 71682 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 71702 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71742 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 71788 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

71789 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 129 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

71790 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

71795 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

71810 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 71818 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 71834 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 71837 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71849 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71869 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71885 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71932 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

71958 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71986 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

72003 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

72010 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

72062 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 72087 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 72101 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

72132 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

72147 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 130 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

72163 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 72222 Public Employee & Pension/Retiree2 7/2/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 72225 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

72232 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 72311 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

72320 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

72336 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 72394 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

72514 Public Employee & Pension/Retiree 11/13/2020 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

72530 Public Employee 7/13/2021 DEPARTMENT OF EDUCATION Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

72600 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

72628 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

72640 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

72670 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

72678 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 72741 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

72753 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 72756 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

72760 Public Employee & Pension/Retiree 6/10/2021 Department of Agriculture, Department of Housing Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 131 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

72780 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

72781 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

72785 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

72803 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

72820 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

72872 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

72875 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

72887 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 72901 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

72911 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 72935 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 72947 Public Employee 5/4/2021 Emergency and Disaster Management Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

72963 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 72964 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

72987 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

73003 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

73032 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

73045 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 132 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

73051 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

73067 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 73071 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

73076 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

73093 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

73122 Public Employee 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 73145 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

73166 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

73171 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 73202 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 73210 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 73253 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 73263 Tax Refund 5/4/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

73266 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

73270 Public Employee & 

Pension/Retiree2 11/13/2020

Department of Agriculture & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

73302 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 73351 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

73377 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

73379 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 133 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

73407 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

73424 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

73426 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 73444 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 73467 Public Employee & Union Grievance 7/29/2022 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

73471 Pension/Retiree 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

73531 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

73553 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

73556 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 73588 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

73596 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 73651 Public Employee & Pension/Retiree 6/10/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

73698 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

73701 Public Employee 5/4/2021 Department of Sports and Recreation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

73755 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

73757 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 73815 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

73819 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

73845 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 134 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

73865 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 73899 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

73956 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 73958 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

73977 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

73978 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

74005 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

74016 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

74033 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

74050 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

74111 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

74138 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

74147 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

74168 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 74176 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

74203 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

74209 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

74311 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

74339 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 135 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

74348 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

74388 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

74394 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

74413 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Family and Children Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

74456 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

74518 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 74520 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

74532 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 74533 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

74582 Public Employee & Pension/Retiree 6/10/2021 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 74610 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

74689 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

74760 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

74769 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 General Services Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 74779 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

74797 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

74817 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

74848 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

74905 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 136 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

74908 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 74923 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 74944 Public Employee & Pension/Retiree2 5/4/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 74998 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

75012 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

75023 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

75089 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

75119 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

75135 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

75143 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

75164 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

75179 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 75218 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

75240 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

75243 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 75257 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

75291 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

75308 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

75339 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 137 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

75435 Public Employee 5/4/2021 Public Service Regulatory Board Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

75438 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

75441 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

75581 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

75613 Public Employee & 

Pension/Retiree2 6/10/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

75626 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

75635 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

75648 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

75657 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

75686 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

75692 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

75711 Public Employee & Pension/Retiree 6/10/2021 Department of Treasury Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

75725 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

75739 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

75756 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

75792 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

75813 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

75895 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

75907 Public Employee 3/30/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 138 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

75924 Public Employee 5/4/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 75950 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

75964 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

75976 Public Employee 4/21/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

75981 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

75995 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 76052 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 76070 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 76105 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76119 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76129 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76131 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76138 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76217 Public Employee 6/10/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76250 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76253 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

76257 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76287 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76294 Public Employee 5/4/2021 Department of Agriculture Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 139 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

76299 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76303 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 76317 Public Employee 3/30/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76360 Public Employee & Pension/Retiree 10/22/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

76378 Public Employee3 11/11/2020 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76382 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76390 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

76484 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76490 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 76503 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 76532 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

76538 Public Employee & Pension/Retiree 6/10/2021 Department of Justice Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

76557 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76569 Public Employee & 

Pension/Retiree2 5/4/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76607 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

76629 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

76654 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76678 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 76719 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 140 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

76754 Public Employee & 

Pension/Retiree2 5/4/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76790 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

76802 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76808 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

76830 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 76870 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76894 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76895 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 76900 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76914 Public Employee 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 76955 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76959 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

76975 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 76990 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 76999 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 77027 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

77047 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 77048 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

77061 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 141 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

77083 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

77103 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

77120 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

77197 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

77211 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

77261 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

77264 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

77327 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

77333 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

77339 Public Employee, Pension/Retiree & Union Grievance 6/10/2021

Mental Health Services and Addiction Control Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

77387 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

77388 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 77452 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

77495 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

77567 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

77587 Public Employee 7/13/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

77643 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 77702 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

77710 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 142 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

77734 Public Employee 12/20/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 77745 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

77748 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

77753 Public Employee 12/20/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 77787 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

77790 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

77819 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

77827 Public Employee 6/10/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

77830 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

77871 Public Employee 12/20/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

77944 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

77955 Public Employee & 

Pension/Retiree2 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

77987 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

78056 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

78057 Public Employee & Pension/Retiree 10/22/2020 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

78110 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education and Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

78111 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

78121 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

78191 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 143 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

78201 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

78231 Public Employee 10/22/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

78254 Public Employee & Pension/Retiree 11/11/2020 Department of Agriculture, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

78273 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 78305 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

78328 Public Employee 6/10/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

78331 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 78357 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

78398 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

78406 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

78423 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

78430 Public Employee & 

Pension/Retiree2 6/10/2021

Department of Labor and Human Resources, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

78498 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

78518 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

78523 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

78530 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

78566 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

78584 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

78606 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 144 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

78609 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

78618 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 78623 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

78665 Public Employee 5/4/2021 Department of Agriculture Y N/A Y Y N/A N N/A 78717 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

78721 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

78729 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 78839 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

78868 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 78886 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 78945 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

78954 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

79004 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

79027 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 79081 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

79090 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

79110 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

79179 Union Grievance 7/2/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 79191 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 145 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

79197 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 79292 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

79318 Public Employee 5/4/2021 Department of Agriculture Y N/A Y Y N/A N N/A 79323 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

79345 Public Employee & Union Grievance 7/29/2022 Department of Health Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

79350 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

79412 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

79481 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

79562 Public Employee 5/4/2021 Department of Justice Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

79583 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

79586 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

79610 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

79634 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

79636 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

79641 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

79684 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 79695 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

79704 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

79710 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 146 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

79728 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 79748 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 79772 Public Employee & 

Pension/Retiree2 6/10/2021

Child Support Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

79796 Public Employee 5/4/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 79826 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

79862 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

79870 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

79884 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

79916 Public Employee & Union Grievance 7/29/2022 Highway and Transportation Authority Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

79944 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

79947 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

79970 Public Employee & Union Grievance 6/10/2021 Public Housing Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

79973 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

79977 Public Employee 6/10/2021 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

80042 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 80054 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

80067 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

80110 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

80137 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 147 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

80154 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 80155 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

80163 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

80167 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 80174 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

80181 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 80240 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

80274 Public Employee 5/4/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 80288 Public Employee & Pension/Retiree 11/11/2020

Family and Children Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

80302 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

80304 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

80309 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

80337 Public Employee & 

Pension/Retiree2 5/4/2021 Public Service Appellate Commission Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

80349 Public Employee 6/10/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

80356 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

80379 Public Employee & Pension/Retiree2 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 80383 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

80437 Pension/Retiree 11/6/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review7 

80474 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 148 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

80482 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

80500 Public Employee & 

Pension/Retiree2 5/4/2021 Office of Court Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

80512 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

80528 Public Employee 1/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

80529 Public Employee & Union Grievance 7/29/2022 Department of Family, Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 80532 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

80598 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

80617 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

80619 Public Employee 11/13/2020 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

80635 Public Employee & Pension/Retiree 1/4/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

80660 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

80685 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

80697 Public Employee 5/4/2021 Department of Health, AFASS - Hospital Regional - Caguas, Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 80724 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

80729 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

80734 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 80760 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

80763 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

80771 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 149 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

80811 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 80828 Public Employee & Pension/Retiree 6/10/2021 Family and Children Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

80839 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

80866 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 80909 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

80913 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

80935 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 80945 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

80960 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

80964 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 81011 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 81068 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

81069 Public Employee & Pension/Retiree 3/30/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

81078 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

81085 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 81087 Public Employee & Pension/Retiree 6/10/2021 Correctional Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

81106 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

81135 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

81155 Public Employee 5/4/2021 Administration of Youth Institutions Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 150 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

81170 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 81203 Public Employee3 11/11/2020

Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

81207 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 81222 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

81230 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

81337 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 81346 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 81361 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

81374 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 81405 Public Employee & Union Grievance 6/24/2022 Department of Correction and Rehabilitation Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

81414 Public Employee 12/20/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

81465 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

81529 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

81539 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

81552 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

81576 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 81577 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

81579 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 81661 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 151 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

81662 Public Employee 11/11/2020 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 81700 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 81716 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

81765 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

81767 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

81783 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 81792 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

81832 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

81838 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

81862 Public Employee & 

Pension/Retiree2 6/10/2021

Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

81957 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

81999 Public Employee & 

Pension/Retiree2 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

82031 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

82032 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 82086 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

82116 Public Employee & 

Pension/Retiree2 11/13/2020

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

82118 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

82119 Public Employee & 

Pension/Retiree4 11/11/2020

Socioeconomic Development of the Family Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

82128 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 152 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

82135 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

82141 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

82146 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

82167 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

82188 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 82201 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

82238 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

82250 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

82285 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

82292 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

82304 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

82324 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

82372 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

82376 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

82422 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

82474 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

82476 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 82482 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 82491 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 153 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

82509 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 82513 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

82536 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

82541 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

82590 Public Employee & 

Pension/Retiree2 5/4/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

82607 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

82614 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

82616 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

82719 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 82782 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

82837 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

82841 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

82895 Pension/Retiree 11/11/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

82917 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

82938 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

82977 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

82990 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

83024 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

83075 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 154 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

83078 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

83149 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

83216 Public Employee 6/10/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 83219 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

83227 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

83235 Public Employee3 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

83253 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

83300 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 83315 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 83321 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

83357 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

83370 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

83470 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

83519 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 83523 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

83541 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

83556 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

83584 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 83591 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 155 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

83696 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

83713 Public Employee & Pension/Retiree 6/10/2021 Permits Management Office, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

83721 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

83735 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

83763 Public Employee3 6/10/2021 Department of Sports and Recreation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

83764 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

83769 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

83771 Public Employee & Pension/Retiree 10/22/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

83776 Public Employee 6/10/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

83779 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 83784 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

83787 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

83827 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

83871 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

83933 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

83966 Public Employee & 

Pension/Retiree2 3/30/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

83987 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

83998 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

83999 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 156 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

84002 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

84053 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

84063 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

84064 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 84077 Public Employee & Pension/Retiree 3/30/2021 Child Support Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 84094 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

84113 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

84144 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

84184 Public Employee & Pension/Retiree 7/29/2022 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting response N N/A 

84201 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

84229 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 84256 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

84327 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 84338 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

84341 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

84344 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

84345 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

84352 Public Employee 5/4/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

84426 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 157 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

84449 Public Employee3 6/10/2021 National Guard of Puerto Rico Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

84465 Public Employee 7/29/2022 Mental Health Services and Addiction Control Administration Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

84582 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 84725 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

84748 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

84774 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

84792 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

84808 Public Employee & Pension/Retiree 3/30/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

84810 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

84815 Public Employee 3/30/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

84844 Public Employee & Pension/Retiree 11/11/2020 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

84846 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

84873 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

84874 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

84917 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 84975 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 84980 Public Employee 3/30/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

84998 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85009 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 158 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

85034 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

85046 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

85092 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

85095 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 85096 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85099 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85106 Public Employee & Pension/Retiree 3/30/2021 Office of Court Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

85123 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85124 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85126 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

85132 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 85145 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

85188 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

85204 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85208 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 85253 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 85279 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85297 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 85316 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 159 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

85318 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 85329 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85406 Public Employee & Pension/Retiree 7/13/2021 Department of Justice, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 85446 Public Employee3 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85468 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 85472 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85481 Public Employee 11/11/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85530 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 85565 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 85586 Public Employee 7/29/2022 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85593 Public Employee 11/11/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85596 Public Employee 11/11/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85598 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85628 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85649 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

85650 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85656 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 85705 Public Employee 6/10/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85715 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 160 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

85717 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85750 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

85791 Public Employee & Pension/Retiree 6/10/2021 Program of Youth Affairs & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 85812 Public Employee 6/10/2021 Public Housing Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85816 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

85844 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

85860 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 85894 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

85896 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

85898 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

85924 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

85948 Public Employee 11/11/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

85954 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

85980 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 85998 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

86004 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

86074 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

86108 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

86144 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 161 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

86189 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

86199 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 86213 Public Employee & Pension/Retiree 3/30/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 86229 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

86235 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 86264 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

86288 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

86290 Public Employee3 6/10/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

86343 Public Employee 7/2/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

86350 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

86352 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

86363 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 86369 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 86370 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

86375 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 86403 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

86428 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

86437 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 86474 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 162 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

86548 Public Employee 11/11/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

86572 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 86580 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

86604 Public Employee & Union Grievance 6/24/2022 Department of Education Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

86609 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

86617 Public Employee & Pension/Retiree 6/10/2021 Department of Justice Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

86660 Pension/Retiree 11/13/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

86662 Public Employee 11/13/2020 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

86673 Public Employee & Pension/Retiree 3/30/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

86705 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

86706 Public Employee & Pension/Retiree 6/10/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

86725 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

86778 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

86780 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

86802 Public Employee & 

Pension/Retiree2 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

86843 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 86875 Public Employee 6/10/2021 Department of Health, Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 86880 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 86893 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 163 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

86915 Public Employee & 

Pension/Retiree4 3/5/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

86920 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

86930 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

87005 Public Employee 11/11/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

87062 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

87100 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

87111 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

87195 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 87273 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

87275 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

87322 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

87325 Public Employee & 

Pension/Retiree2 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

87366 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 87375 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

87376 Public Employee & Pension/Retiree 7/13/2021

Department of Economic Development and Commerce, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

87379 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

87398 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

87400 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

87404 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 164 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

87418 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

87462 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

87472 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

87473 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

87477 Public Employee 11/11/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

87480 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 87514 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

87552 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 87554 Public Employee 5/4/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 87581 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

87591 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

87592 Public Employee 6/10/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

87617 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

87621 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 87637 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 87695 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

87743 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

87765 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

87833 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 165 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

87871 Public Employee 3/30/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

87889 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

87914 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

87918 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

87926 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

87939 Public Employee & Pension/Retiree 6/10/2021 Pretrial Services Program, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 87954 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 87967 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88022 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 88030 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 88047 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 88086 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

88093 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 88096 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

88131 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88159 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88184 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88190 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88198 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 166 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

88202 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 88224 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88242 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

88246 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88311 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88365 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88368 Public Employee & Pension/Retiree 6/10/2021 Department of Health & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 88370 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

88392 Public Employee & Pension/Retiree 7/13/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 88418 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88429 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 88459 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 88463 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation, Administration of Correction Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 88482 Public Employee 3/30/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88548 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 88552 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

88564 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

88600 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 88674 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 167 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

88690 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88703 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 88739 Public Employee 11/11/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88750 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88751 Public Employee & Union Grievance 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

88760 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88764 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

88777 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

88816 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88818 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

88838 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88857 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 88860 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88863 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88865 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 88882 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 88892 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 88953 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

88958 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 168 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

88972 Public Employee & 

Pension/Retiree2 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

89029 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

89031 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

89053 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 89097 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

89110 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

89128 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

89204 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

89214 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

89239 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

89294 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

89301 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

89321 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

89367 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 89430 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

89449 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

89465 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

89474 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

89479 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 169 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

89484 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

89502 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

89507 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

89545 Public Employee 5/4/2021 Department of Health, Pediatric Hospital Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

89555 Public Employee & Pension/Retiree 11/13/2020 Department of Health & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

89567 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

89627 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

89644 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

89680 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

89704 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

89722 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

89724 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

89746 Public Employee & Pension/Retiree 7/13/2021 Department of Health & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 89760 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

89766 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

89809 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

89812 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

89833 Public Employee & Pension/Retiree 3/30/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

89877 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 170 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

89923 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

89930 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

89941 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 89945 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 89951 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

89955 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 89996 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90014 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

90048 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

90076 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 90127 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 90134 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 90170 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

90192 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90201 Public Employee & 

Pension/Retiree2 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90214 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90228 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90231 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 90250 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 171 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

90293 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90299 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

90309 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90316 Public Employee & 

Pension/Retiree2 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90328 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90332 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

90353 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 90367 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 90371 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

90376 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

90435 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 90445 Public Employee & Pension/Retiree 6/10/2021 Administration of Correction Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

90451 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90456 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

90463 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 90474 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90485 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

90492 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90525 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 172 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

90581 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 90590 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

90595 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 90607 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

90625 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 90628 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90634 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90653 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 90665 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 90668 Public Employee & Pension/Retiree 6/10/2021 Department of Labor and Human Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

90690 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 90708 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

90715 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 90733 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90738 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 90745 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90750 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90786 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90802 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 173 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

90831 Public Employee 5/4/2021 Administration of Correction Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90849 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90866 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90874 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 90889 Pension/Retiree1 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

90900 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90963 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

90965 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90967 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

90971 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

91014 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

91058 Public Employee & Pension/Retiree 3/30/2021 Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 91063 Public Employee & Pension/Retiree2 3/30/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 91065 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 91076 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 91083 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

91092 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

91107 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

91118 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 174 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

91122 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

91143 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

91155 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

91160 Public Employee 3/30/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

91163 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

91189 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 91240 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

91261 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

91334 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

91336 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 91341 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

91351 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

91370 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

91373 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

91384 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

91396 Public Employee 12/20/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 91424 Public Employee & Pension/Retiree 6/10/2021 Department of Public Safety Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

91432 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

91438 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 175 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

91443 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

91472 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

91481 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

91482 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

91526 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

91537 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 91625 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

91626 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

91647 Public Employee & Pension/Retiree 3/30/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

91648 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

91656 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

91666 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

91667 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

91705 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

91721 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

91736 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 91761 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

91786 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 91814 Public Employee & Pension/Retiree 6/10/2021 Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 176 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

91891 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

91916 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

91948 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 91950 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

91958 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 91976 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

91985 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 92093 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

92114 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 92126 Public Employee 5/4/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 92146 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

92161 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 92166 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

92188 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

92207 Public Employee & Pension/Retiree 6/10/2021 Public Building Authority, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 92236 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 92334 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

92335 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

92336 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 177 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

92360 Public Employee & 

Pension/Retiree2 11/11/2020

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

92367 Public Employee 6/10/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 92379 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

92383 Public Employee & 

Pension/Retiree2 11/11/2020

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

92422 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

92470 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

92473 Pension/Retiree1 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

92474 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

92512 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

92518 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

92543 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

92547 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

92556 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 92559 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

92609 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

92646 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

92716 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

92754 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 92794 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 178 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

92825 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

92827 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 92867 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

92885 Public Employee & Pension/Retiree 3/30/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

92903 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 92928 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

92931 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

92992 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

93009 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 93012 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

93044 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

93049 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

93066 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

93090 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

93099 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 93101 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

93196 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 93232 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 93240 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 179 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

93243 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 93261 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

93332 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

93354 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 93406 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 93431 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 93500 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 93504 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

93534 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

93585 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

93592 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 93594 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

93603 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

93630 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

93636 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

93646 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

93661 Public Employee 7/29/2022 Department of Correction and Rehabilitation Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

93688 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

93712 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 180 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

93751 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

93752 Pension/Retiree 10/29/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

N Claim amended by subsequently filed claim N N N/A N N/A 

93771 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

93788 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

93811 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

93839 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

93861 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 93876 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

93889 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 93899 Public Employee 5/4/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 93911 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

93918 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 93928 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

93945 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

93946 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

93962 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 93963 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 93999 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

94006 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 181 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

94047 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

94057 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

94091 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

94093 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 94095 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

94108 Public Employee & Pension/Retiree 6/10/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 94118 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

94127 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

94170 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 94185 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

94211 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 94213 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

94235 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

94246 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 94278 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

94314 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

94363 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

94377 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

94383 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 182 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

94398 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 94402 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

94432 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 94468 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

94517 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

94543 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 94548 Public Employee 5/4/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 94554 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

94571 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

94597 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 94624 Public Employee 5/4/2021 Public Service Commission Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

94627 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

94628 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 94629 Public Employee & Pension/Retiree2 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 94642 Public Employee & Pension/Retiree 6/10/2021 Department of Justice Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

94666 Public Employee3 11/11/2020 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

94723 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

94758 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

94805 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 183 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

94824 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

94826 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

94849 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

94855 Public Employee & Pension/Retiree 3/30/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 94876 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

94910 Public Employee & Pension/Retiree2 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 94937 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

94950 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

94954 Pension/Retiree 11/11/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

94969 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 94987 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

95017 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 95030 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

95056 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 95071 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

95121 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

95144 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

95159 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

95168 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 184 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

95169 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

95194 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 95221 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 95225 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

95315 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

95335 Public Employee 11/11/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

95363 Public Employee & Pension/Retiree 3/30/2021 General Services Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

95366 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

95393 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

95420 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

95490 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

95493 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

95523 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

95550 Public Employee 6/10/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

95630 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

95648 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

95671 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

95770 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

95774 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 185 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

95789 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 95812 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

95818 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 95820 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

95835 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 95847 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

95857 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

95887 Public Employee 5/4/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 95959 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 95964 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

95972 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

95986 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

95994 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

96007 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 96018 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 96039 Public Employee 5/4/2021 Department of Agriculture Y N/A Y Y N/A N N/A 96048 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 96051 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

96059 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 186 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

96060 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

96063 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

96068 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 96092 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

96117 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

96126 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 96149 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

96159 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

96182 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

96185 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

96191 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

96192 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 96201 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

96206 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

96207 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

96218 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

96264 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

96269 Public Employee & 

Pension/Retiree4 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

96273 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 187 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

96285 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

96287 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

96294 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

96299 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

96348 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

96370 Public Employee3 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

96373 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

96441 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

96455 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 96478 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 96505 Public Employee & Pension/Retiree 3/30/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

96516 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

96530 Public Employee 5/4/2021 State Elections Commission Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

96538 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

96560 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

96598 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 96619 Public Employee & 

Pension/Retiree2 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

96665 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

96682 Public Employee & Pension/Retiree 6/10/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 188 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

96709 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 96760 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

96837 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

96846 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 96854 Public Employee3 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

96856 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

96881 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 96887 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

96915 Union Grievance 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

96920 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 96958 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

96966 Public Employee 11/11/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

96969 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

96980 Public Employee 11/11/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

96987 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

97035 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

97063 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

97082 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97102 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 189 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

97171 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Health and Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97215 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

97237 Public Employee 12/20/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 97249 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

97264 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97277 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97340 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 97386 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97435 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 97468 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 97490 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 97497 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

97509 Public Employee 7/29/2022 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97518 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97526 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

97534 Public Employee & 

Pension/Retiree2 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97544 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97555 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97557 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 190 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

97559 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

97563 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

97574 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 97588 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

97598 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 97624 Public Employee & Pension/Retiree2 3/30/2021 State Elections Commission Y N/A Y Y N/A N N/A 97635 Public Employee & Pension/Retiree2 5/4/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 97637 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 97638 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97639 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 97650 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97652 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

97673 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

97690 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education and Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97692 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

97705 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 97708 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97746 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

97757 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 191 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

97758 Public Employee 10/22/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97765 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 97811 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97833 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97842 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97886 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97896 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 97902 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 97942 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 97948 Public Employee & Pension/Retiree 10/22/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

97983 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97995 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

98003 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

98068 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

98120 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

98123 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Department of Justice Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

98126 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

98146 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

98196 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 192 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

98199 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 98212 Public Employee3 6/10/2021 National Guard of Puerto Rico Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

98214 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 98234 Public Employee3 6/10/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

98300 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 98301 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

98325 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

98349 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

98360 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

98374 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 98380 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 98462 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

98464 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

98475 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

98476 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

98505 Public Employee & Pension/Retiree 3/30/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 98524 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

98547 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

98554 Public Employee 3/30/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 193 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

98559 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

98567 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

98614 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 98644 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

98673 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

98759 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

98769 Public Employee 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 98810 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

98830 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

98833 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

98866 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

98884 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 99000 Public Employee 5/4/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 99006 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 99022 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99045 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99056 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 99065 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

99079 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 194 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

99125 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99136 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 99153 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99190 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99193 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

99197 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 99203 Public Employee 6/10/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99205 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99265 Public Employee & Pension/Retiree 10/22/2020

Department of Family, Socioeconomic

Development of the Family Administration & Employees Retirement System of the Government of the Commonwealth of Puerto 

Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99270 Public Employee 3/30/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

99272 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99286 Public Employee & Pension/Retiree 6/10/2021 Public Service Commission Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

99299 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 99301 Public Employee & 

Pension/Retiree2 5/4/2021 Administration for the Training of Future Entrepreneurs and Workers Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

99337 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

99359 Public Employee & Pension/Retiree 6/10/2021

Socioeconomic Development of the Family Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99375 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99379 Public Employee & Union Grievance 11/11/2020 AFASS Health Ponce Region, Department of Health, Program for people with intellectual Disabilities Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

99386 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 195 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

99397 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

99475 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

99489 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

99501 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 99506 Public Employee & Pension/Retiree 3/30/2021 Office of Court Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 99508 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 99523 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99541 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99612 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99613 Public Employee & Union Grievance 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

99626 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99633 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

99680 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99701 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 99728 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 99739 Public Employee & Pension/Retiree 3/30/2021

Department of Economic Development and Commerce, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99917 Public Employee & Pension/Retiree 3/30/2021

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99918 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99937 Public Employee 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 196 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

99938 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99969 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99982 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100031 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100035 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100069 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100073 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100091 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

100102 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

100113 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100125 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

100137 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100165 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

100188 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

100191 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

100241 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 100254 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100271 Public Employee & Pension/Retiree 6/10/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 100301 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 197 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

100330 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100338 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

100360 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100382 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Natural and Environmental Resources, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100390 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100404 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 100420 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100421 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100426 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100464 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100484 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100513 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100543 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

100571 Public Employee & 

Pension/Retiree2 5/4/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100615 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100637 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

100646 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

100648 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100657 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 198 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

100681 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100682 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 100689 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100706 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100798 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100853 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 100859 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

100870 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100911 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

100950 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100957 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100973 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

100980 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 101008 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

101036 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

101064 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health, Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

101066 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

101111 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

101120 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 199 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

101141 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

101183 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 101184 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 101190 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

101203 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 101220 Public Employee & Pension/Retiree 6/10/2021 Corps of Firefighters Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

101241 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 101248 Public Employee & Pension/Retiree 6/10/2021

Socioeconomic Development of the Family Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

101255 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 101256 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

101261 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

101280 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 101285 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

101297 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 101300 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 101330 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

101343 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

101443 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 200 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

101452 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 101454 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 101487 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

101491 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

101535 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

101536 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

101562 Public Employee & 

Pension/Retiree2 11/11/2020

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

101584 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 101712 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

101714 Pension/Retiree1 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

101770 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

101803 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 101810 Public Employee & 

Pension/Retiree2 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

101814 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

101839 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

101872 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

101887 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 101904 Public Employee & Pension/Retiree 6/10/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

101928 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 201 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

102008 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 102013 Public Employee & Union Grievance 6/10/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

102021 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 102047 Public Employee & 

Pension/Retiree2 11/13/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

102103 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

102114 Public Employee & Union Grievance 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

102169 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 102209 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

102220 Public Employee & Pension/Retiree2 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 102223 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 102235 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

102252 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 102261 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

102262 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

102278 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

102284 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

102322 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

102342 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

102343 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 202 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

102347 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

102360 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

102425 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 102450 Public Employee 5/4/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 102463 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 102476 Public Employee & Pension/Retiree 11/11/2020 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

102489 Public Employee 6/10/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

102539 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

102607 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

102616 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

102704 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 102710 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

102752 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

102781 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

102794 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 102795 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 102836 Public Employee & Pension/Retiree 1/4/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

102840 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 102849 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 203 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

102857 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 102864 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

102866 Public Employee & 

Pension/Retiree4 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Puerto Rico Police Bureau

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

102894 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 102906 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

102908 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 102914 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

102916 Public Employee 5/4/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

102935 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

102947 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

102948 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

102970 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

102974 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

102986 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

102996 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

102999 Public Employee 1/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

103036 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

103081 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

103132 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 204 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

103145 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

103191 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

103256 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

103286 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

103298 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

103341 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

103399 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

103424 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

103459 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

103479 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

103568 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

103573 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Housing Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

103584 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 103608 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

103648 Public Employee3 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

103656 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 103667 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

103675 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

103705 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 205 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

103709 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

103710 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

103713 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

103732 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

103738 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 103746 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

103750 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 103824 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 103835 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

103848 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 103849 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

103876 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

103887 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

103894 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

103905 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

103911 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

103920 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

103924 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 103926 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 206 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

103934 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 103949 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

104008 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

104018 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

104050 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

104068 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

104071 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104082 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

104101 Public Employee & Pension/Retiree 6/10/2021 Family and Children Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

104104 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

104109 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

104117 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104124 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104133 Public Employee & 

Pension/Retiree4 3/5/2021

Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

104166 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104196 Public Employee & Pension/Retiree 6/10/2021 Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104207 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

104230 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104246 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 207 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

104258 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104259 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

104263 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104304 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104321 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

104334 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

104339 Public Employee 11/11/2020 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

104346 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

104349 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

104379 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

104386 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104413 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

104419 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104421 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104434 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

104439 Public Employee & Pension/Retiree 6/10/2021 Department of Public Safety, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104444 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

104465 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

104474 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 208 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

104503 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

104507 Public Employee & Pension/Retiree 7/13/2021 Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104516 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104526 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104536 Public Employee & Pension/Retiree 3/30/2021 General Services Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104556 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104565 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

104598 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104655 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

104690 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

104693 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

104697 Public Employee 11/11/2020 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104703 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

104713 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

104723 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104737 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104792 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 104824 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

104934 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 209 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

104956 Public Employee3 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

105043 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

105087 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 105141 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

105148 Public Employee & Pension/Retiree 6/10/2021 General Court of Justice Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

105212 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 105215 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

105268 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

105278 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

105293 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 105304 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

105305 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

105362 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

105364 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

105378 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

105395 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 105403 Public Employee3 3/30/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

105414 Pension/Retiree1 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

105446 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 210 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

105450 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 105487 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

105499 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

105501 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 105519 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 105590 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 105605 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 105628 Public Employee & Pension/Retiree2 11/11/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

105653 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 105662 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

105670 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

105705 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

105724 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

105766 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

105776 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

105859 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

105860 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

105908 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

105914 Public Employee & Pension/Retiree 6/10/2021

Department of Housing, Housing Development

and Improvement Administration, Administration of Social Programs, Rural Housing Administration, Administration 

development improvements sale

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 211 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

105916 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

105935 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

105961 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

105963 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 105994 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

106006 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

106016 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

106019 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

106022 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106049 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

106054 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

106092 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106103 Public Employee & Pension/Retiree 3/30/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

106106 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

106118 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

106143 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

106207 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106211 Public Employee 3/30/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

106241 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 212 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

106251 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

106275 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106276 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106295 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

106325 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

106341 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106359 Public Employee 10/22/2020 Department of Family, Family and Children Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106366 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106370 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106372 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106394 Public Employee 7/13/2021 Urban Housing Renovation Corporation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

106414 Public Employee & Pension/Retiree2 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

106459 Public Employee & Pension/Retiree 11/11/2020

Department of Health, Administration of Health Facilities and Services & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

106463 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106475 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106480 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

106492 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

106530 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106535 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 213 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

106539 Public Employee & Pension/Retiree 6/10/2021 Department of Health & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106545 Public Employee 5/4/2021 Administration of Youth Institutions Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

106559 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106599 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106612 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

106617 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106638 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

106643 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

106686 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106691 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

106696 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

106698 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

106720 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

106722 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

106737 Public Employee3 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

106784 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106787 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

106788 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106796 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 214 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

106843 Public Employee 5/4/2021 Public Service Commission Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

106847 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

106864 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106869 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 106990 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

107032 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

107039 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

107088 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

107099 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 107154 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 107206 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 107229 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

107235 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 107272 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

107282 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

107343 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

107354 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 107361 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

107382 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 215 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

107409 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

107421 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

107432 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 107436 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

107460 Public Employee & Pension/Retiree 7/13/2021 Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

107482 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

107492 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

107529 Public Employee & 

Pension/Retiree2 5/4/2021 Office of Court Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

107537 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

107539 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 107566 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

107603 Public Employee & 

Pension/Retiree2 5/4/2021 Office of Court Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

107604 Public Employee & Pension/Retiree 6/10/2021

Mental Health Services and Addiction Control Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

107611 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 107637 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 107681 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

107707 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

107710 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

107724 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 216 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

107758 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

107769 Public Employee & 

Pension/Retiree2 3/30/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

107771 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

107786 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

107821 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 107831 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 107888 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 107890 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

107954 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

107962 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 108032 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

108040 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

108049 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

108053 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

108092 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

108094 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 108106 Public Employee 5/4/2021 Administration of Youth Institutions Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

108118 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

108165 Public Employee 7/13/2021 Department of Education Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 217 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

108199 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

108207 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 108218 Public Employee & Pension/Retiree 6/10/2021 Office of Court Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

108294 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

108306 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 108307 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

108320 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

108337 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 108351 Public Employee3 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

108385 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

108412 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 108433 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 108437 Public Employee & Pension/Retiree 7/13/2021

Department of Sports and Recreation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

108442 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

108447 Public Employee & Pension/Retiree 6/10/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 108451 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

108460 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

108465 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 108528 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 218 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

108567 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

108604 Public Employee & Pension/Retiree 7/29/2022 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 108605 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

108612 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

108626 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

108656 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

108657 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 108681 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

108689 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

108702 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 108714 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

108773 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

108794 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 108802 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

108818 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

108856 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

108902 Public Employee & Pension/Retiree 11/11/2020 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

108905 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

108914 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 219 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

108953 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

108955 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 108962 Public Employee & Pension/Retiree 3/30/2021 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 108996 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

109009 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 109026 Public Employee 5/4/2021 National Guard of Puerto Rico Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

109028 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

109033 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

109112 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

109121 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

109123 Public Employee & 

Pension/Retiree4 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

109169 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

109170

Union Grievance & Pension/Retiree5 7/13/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

109206 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 109222 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

109244 Public Employee & Pension/Retiree 6/10/2021 Department of Justice Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

109258 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 109272 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

109289 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 220 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

109293 Public Employee & Pension/Retiree 6/10/2021 Department of Labor and Human Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

109294 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

109295 Public Employee & Pension/Retiree 7/13/2021 Department of Social Services, Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

109300 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

109331 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

109340 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 109344 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 109346 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

109379 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

109409 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

109433 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

109450 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

109456 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

109487 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

109497 Pension/Retiree 3/5/2021

Employees Retirement System of the 

Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

109500 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

109504 Public Employee & Pension/Retiree 3/30/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 109511 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 109547 Public Employee & 

Pension/Retiree2 3/30/2021 Child Support Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 221 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

109555 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

109592 Public Employee3 3/30/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

109598 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 109601 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

109636 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 109652 Public Employee & 

Pension/Retiree4 3/5/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

109653 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

109676 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

109706 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 109711 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

109758 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 109767 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

109779 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

109786 Public Employee 7/29/2022 Department of Education Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

109814 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

109830 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

109861 Public Employee3 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

109872 Public Employee & Pension/Retiree 6/10/2021 Department of Health & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 109884 Public Employee 12/20/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 222 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

109894 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

109901 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 109928 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

109950 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

109956 Pension/Retiree 11/11/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

110030 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 110032 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

110036 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

110072 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

110190 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

110193 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

110230 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

110242 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 110316 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

110333 Public Employee 6/10/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

110343 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 110348 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

110377 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 110383 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 223 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

110427 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

110465 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 110474 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 110486 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

110491 Public Employee & Pension/Retiree2 11/13/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

110509 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 110560 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

110588 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 110613 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

110619 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

110638 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

110669 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

110676 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

110705 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

110712 Public Employee 7/13/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

110714 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 110717 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

110723 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

110767 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 224 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

110775 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 110804 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 110837 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 110838 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

110866 Public Employee & Pension/Retiree 1/4/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

110884 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

110886 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

110919 Public Employee & Pension/Retiree 6/10/2021

Socioeconomic Development of the Family Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

110922 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

110934 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

110956 Public Employee & Pension/Retiree 6/10/2021 National Guard of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

110961 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

110972 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

110981 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111007 Public Employee 11/13/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111019 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 111025 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 111027 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

111034 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 225 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

111045 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 111061 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 111110 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

111128 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 111150 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

111171 Public Employee & Pension/Retiree2 7/2/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 111175 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

111223 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111242 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 111311 Public Employee 11/11/2020 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111336 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111353 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

111355 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111371 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111392 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 111410 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

111416 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 111434 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 111446 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 226 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

111478 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111506 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 111513 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 111580 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

111607 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111629 Public Employee & Pension/Retiree 6/10/2021

Socioeconomic Development of the Family Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111682 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111721 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

111740 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111766 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 111774 Public Employee & 

Pension/Retiree2 6/24/2022 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111786 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111789 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111817 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

111857 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111882 Public Employee & Pension/Retiree 6/10/2021 Agency Not Provided Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

111883 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111886 Public Employee 11/11/2020 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111898 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 227 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

111904 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111917 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 111930 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

111940 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111953 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

111954 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 111967 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 111969 Public Employee & 

Pension/Retiree2 6/10/2021

Department of Labor and Human Resources & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112012 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

112013 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

112018 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

112021 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112028 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112043 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112049 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112061 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112071 Public Employee 7/2/2021 Administration of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112087 Public Employee 7/13/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112092 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 228 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

112105 Public Employee 3/30/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112110 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112140 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112142 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112149 Public Employee 3/30/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112158 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112178 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112220 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112227 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112240 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112267 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112287 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112376 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112394 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112396 Public Employee & 

Pension/Retiree2 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

112419 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112425 Public Employee 11/13/2020 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112426 Public Employee & Pension/Retiree 7/13/2021 Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112446 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 229 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

112447 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112479 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112481 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112507 Public Employee 3/30/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112519 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112531 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

112546 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112567 Public Employee 3/30/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112598 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112636 Public Employee & Pension/Retiree 6/10/2021

Socioeconomic Development of the Family Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112670 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112723 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112803 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112809 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112830 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112840 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112864 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112875 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112887 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 230 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

112916 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112918 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112925 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

112939 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112940 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112957 Public Employee & Pension/Retiree 3/30/2021 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 112963 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

112965 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

112993 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113021 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

113026 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

113036 Public Employee & Pension/Retiree 3/30/2021

Mental Health Services and Addiction Control Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

113044 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

113072 Public Employee & Pension/Retiree 6/24/2022 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting response N N/A 

113116 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

113191 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113200 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113204 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113234 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 231 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

113239 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113257 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

113265 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

113269 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113276 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

113277 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113307 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113312 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

113328 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

113330 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113334 Public Employee 6/24/2022 Administration of Correction Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

113361 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

113380 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113391 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

113420 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113450 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

113456 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

113458 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

113492 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 232 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

113521 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

113535 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

113538 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113549 Public Employee3 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

113577 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113594 Public Employee 5/4/2021 Department of Health, Environmental Health Program Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113619 Public Employee & Pension/Retiree 6/10/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

113621 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

113656 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113659 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

113676 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113713 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113725 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

113738 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

113776 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113786 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

113821 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

113849 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113852 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 233 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

113853 Public Employee & Pension/Retiree 8/25/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113870 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

113882 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113921 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113961 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

113971 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 113978 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

114000 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

114001 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

114029 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

114055 Public Employee & Pension/Retiree 6/10/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 114081 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

114082 Public Employee & Pension/Retiree 6/10/2021

Department of Labor and Human Resources, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

114123 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 114189 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

114199 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

114304 Public Employee & 

Pension/Retiree2 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

114325 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

114334 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 234 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

114373 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

114377 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 114407 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

114419 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

114461 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

114465 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 114482 Public Employee & Pension/Retiree 6/10/2021 Department of Family, Department of Social Services Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 114627 Public Employee & Pension/Retiree 6/10/2021 Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 114645 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 114649 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

114666 Public Employee & Pension/Retiree 7/2/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

114706 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 114712 Public Employee 3/30/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

114741 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

114753 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

114758 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

114771 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

114779 Public Employee & Pension/Retiree2 3/30/2021

Department of Labor and Human Resources, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

114810 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 235 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

114868 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 114894 Public Employee & Pension/Retiree 6/10/2021 Department of Housing Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

114920 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

114985 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

114999 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

115024 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

115071 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

115073 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 115082 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

115089 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 115121 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 115147 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

115248 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

115270 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

115327 Public Employee 11/13/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

115367 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

115410 Public Employee 11/13/2020 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

115456 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 115463 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 236 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

115474 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 115490 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 115494 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 115498 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

115517 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

115531 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

115566 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

115572 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

115583 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

115613 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

115623 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

115672 Public Employee 5/4/2021 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

115678 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

115699 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

115732 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 115770 Public Employee & Pension/Retiree 6/10/2021 Department of Labor and Human Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

115771 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 115773 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 115805 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 237 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

115811 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

115814 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

115815 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

115817 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

115830 Public Employee & Pension/Retiree 6/10/2021 Department of Treasury Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

115834 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

115842 Public Employee & Pension/Retiree 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

115844 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

115856 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

115889 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 115895 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 115904 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

115916 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 115923 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

115928 Public Employee & 

Pension/Retiree4 3/5/2021

Office of Court Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

115943 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

115958 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

115994 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

115999 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 238 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

116002 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116008 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116037 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116047 Public Employee & 

Pension/Retiree2 11/13/2020 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

116052 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116098 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116120 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

116122 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116148 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116233 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116240 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

116241 Public Employee & Pension/Retiree 6/10/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116244 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116247 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

116263 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116274 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116275 Public Employee 11/11/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116288 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116321 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 239 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

116338 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116349 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116368 Public Employee 5/4/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116408 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116409 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116480 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116485 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116494 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116498 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116501 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116505 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116540 Public Employee & Pension/Retiree2 3/30/2021

Socioeconomic Development of the Family Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116552 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116553 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116560 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116608 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

116642 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116645 Public Employee & Pension/Retiree 10/22/2020 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

116660 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 240 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

116677 Public Employee & Pension/Retiree 6/10/2021

Socioeconomic Development of the Family Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116688 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

116691 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

116706 Public Employee & 

Pension/Retiree2 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116708 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116714 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116718 Public Employee & Pension/Retiree 6/24/2022 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting response N N/A 

116721 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

116731 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116739 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

116755 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116764 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116768 Public Employee 7/29/2022 No Agency Provided Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

116795 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

116799 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116825 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116834 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

116835 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

116850 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 241 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

116865 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 116889 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

116933 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116954 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116971 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

116973 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 117007 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 117029 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

117031 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

117035 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

117052 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

117088 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

117093 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 117105 Public Employee & Pension/Retiree 6/10/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

117107 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

117143 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 117153 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 117175 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

117181 Public Employee & Pension/Retiree 6/10/2021 Office of Court Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 242 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

117188 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 117197 Public Employee 5/4/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 117224 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

117229 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

117253 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

117296 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

117314 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

117329 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 117406 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

117420 Public Employee 11/13/2020 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

117458 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

117480 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

117483 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 117491 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

117501 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

117529 Public Employee & Pension/Retiree2 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 117539 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 117543 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

117549 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 243 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

117551 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

117553 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

117569 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 117581 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 117584 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 117604 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

117622 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 117625 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 117661 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 117662 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 117665 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

117687 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

117704 Public Employee & Union Grievance 11/13/2020 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

117807 Public Employee & Pension/Retiree2 7/2/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

117840 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

117913 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

117933 Public Employee & Pension/Retiree 6/10/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

117935 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

117960 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 244 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

117975 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118002 Public Employee, Pension/Retiree & Union Grievance 7/29/2022 Department of Family, Department of Social Services Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118027 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118029 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118056 Public Employee3 7/13/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118063 Public Employee & Pension/Retiree 6/10/2021 Administration of Correction Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

118104 Public Employee 5/4/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118107 Public Employee 6/10/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118109 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118133 Public Employee & Pension/Retiree 3/30/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

118216 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118244 Public Employee 11/13/2020 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118288 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118336 Public Employee & Pension/Retiree 6/10/2021 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118338 Public Employee & Pension/Retiree 6/10/2021 Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118353 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

118506 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

118526 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118538 Public Employee & Pension/Retiree 6/10/2021 Corps of Firefighters Bureau, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A Y Y N/A N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 245 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

118543 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118561 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118562 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118578 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118593 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118598 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

118636 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118639 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118646 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118649 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118654 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118667 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118687 Public Employee 5/4/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118688 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118695 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118718 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118725 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

118742 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118751 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 246 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

118760 Public Employee & 

Pension/Retiree4 3/5/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

118792 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

118815 Public Employee & Pension/Retiree2 7/2/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118832 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118863 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118873 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

118913 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 118924 Public Employee & Pension/Retiree 6/10/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

118927 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118928 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118946 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118949 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118951 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118974 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118991 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119012 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

119019 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

119020 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 119028 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 247 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

119032 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119044 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

119089 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119134 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

119136 Public Employee 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 119143 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119172 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119205 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119225 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119243 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

119278 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

119287 Public Employee & Pension/Retiree 6/10/2021 Corps of Firefighters Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

119300 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119311 Public Employee & Pension/Retiree 6/10/2021

Department of Labor and Human Resources, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119379 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

119389 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

119404 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119426 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119427 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 248 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

119430 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 119433 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

119503 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119506 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

119522 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

119533 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

119602 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 119604 Public Employee3 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119607 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 119611 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 119614 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

119632 Public Employee 3/30/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 119635 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

119649 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 119666 Public Employee 6/10/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 119668 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119673 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119674 Public Employee & 

Pension/Retiree2 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

119685 Public Employee & Pension/Retiree 6/10/2021 Agency Not Provided Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 249 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

119688 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119691 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119692 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 119716 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

119746 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

119768 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

119838 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

119849 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 119878 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119898 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119905 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119925 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 119967 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

119993 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 120010 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120025 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120037 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120055 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 120076 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 250 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

120093 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

120097 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 120117 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

120118 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

120124 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120147 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120153 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

120175 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 120183 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

120221 Public Employee & Pension/Retiree 6/10/2021 Department of Correction Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

120245 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

120251 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 120288 Public Employee 11/13/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120316 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120323 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 120331 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 120356 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120362 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120363 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 251 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

120364 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120381 Public Employee & Pension/Retiree 6/10/2021

Mental Health Services and Addiction Control Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120398 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

120424 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 120428 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120436 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 120438 Public Employee & Pension/Retiree 11/13/2020

Vocational Rehabilitation Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120439 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120455 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120458 Public Employee & Pension/Retiree 6/24/2022 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting response N N/A 

120460 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120463 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 120472 Public Employee 5/4/2021 Department of Agriculture Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120480 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 120511 Public Employee & Pension/Retiree 6/10/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 120527 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 120545 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120562 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

120614 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 252 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

120671 Public Employee & 

Pension/Retiree4 3/5/2021

Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120681 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 120710 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120723 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120733 Public Employee 7/2/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120740 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 120785 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 120799 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

120822 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

120825 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

120835 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 120849 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 120858 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

120876 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

120885 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

120916 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

120925 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

120937 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

120999 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 253 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

121040 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

121110 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 121128 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

121131 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121132 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 121135 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121155 Public Employee & Pension/Retiree 6/10/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 121165 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121173 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

121190 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 121191 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 121206 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 121236 Public Employee & 

Pension/Retiree2 6/10/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121243 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

121266 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 121297 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121302 Pension/Retiree 11/6/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

121309 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121333 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 254 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

121348 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121354 Public Employee & Pension/Retiree 6/10/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

121363 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

121384 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 121394 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 121420 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121436 Public Employee 3/30/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121467 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121471 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 121484 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121494 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121498 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

121521 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121522 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 121531 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 121554 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121564 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121592 Pension/Retiree1 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

121604 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 255 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

121643 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121646 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121663 Public Employee 3/30/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121687 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

121745 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

121757 Public Employee 5/4/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121779 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 121798 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 121804 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121825 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

121878 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121906 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

121918 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

121920 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121930 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

121939 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 121941 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

121950 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 121954 Public Employee 3/30/2021 Department of Sports and Recreation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 256 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

121990 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

121998 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 122000 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

122030 Public Employee 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122052 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122063 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122094 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122107 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 122123 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

122171 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122182 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122201 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122220 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 122230 Public Employee & Pension/Retiree 7/13/2021 Department of Health, University Hospital Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

122241 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122250 Public Employee3 6/10/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

122252 Public Employee & Pension/Retiree 6/10/2021 Department of Treasury Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

122253 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

122271 Public Employee 5/4/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 257 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

122292 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 122313 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122337 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

122339 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 122346 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122352 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122371 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122397 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 122411 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122424 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 122425 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 122431 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122453 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

122465 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122472 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 122484 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 122566 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 122594 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 122595 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 258 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

122644 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

122651 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

122662 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 122674 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 122678 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

122684 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122686 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

122698 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122759 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 122786 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 122844 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122891 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 122917 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122925 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 122935 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

122968 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 122971 Public Employee & Pension/Retiree 6/10/2021 Department of Consumer Affairs Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

122974 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

123024 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 259 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

123025 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

123031 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

123062 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

123071 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 123154 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

123164 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 123182 Public Employee & Pension/Retiree 3/30/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 123194 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

123202 Public Employee & 

Pension/Retiree4 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

123207 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

123237 Public Employee 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 123262 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 123290 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

123293 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

123359 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

123408 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

123439 Public Employee 5/4/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 123460 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

123487 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 260 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

123488

Union Grievance & Pension/Retiree5 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

123505 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 123510 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

123513 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 123524 Public Employee3 6/10/2021 Department of Housing Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

123527 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

123544 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 123580 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 123593 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 123602 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 123631 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

123636 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 123639 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 123665 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

123717 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 123753 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

123762 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

123778 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

123787 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 261 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

123799 Public Employee & Pension/Retiree 6/10/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 123812 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

123817 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

123818 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

123829 Public Employee 7/29/2022 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

123865 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

123875 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

123918 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

123945 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 123981 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 123983 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 123994 Public Employee 3/30/2021 Department of Family, Department of Social Services Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124015 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124046 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124050 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124055 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124077 Public Employee & Pension/Retiree 6/10/2021 Office of Court Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124083 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124099 Public Employee & Pension/Retiree 3/30/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 262 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

124101 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124105 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124106 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124107 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

124120 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124135 Public Employee & Pension/Retiree 6/10/2021 Department of Labor and Human Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

124154 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124168 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

124173 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

124174 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124195 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124200 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

124219 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124249 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124264 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124273 Public Employee & Pension/Retiree 3/30/2021 Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124278 Public Employee & Pension/Retiree 6/10/2021

Socioeconomic Development of the Family Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124304 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124384 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 263 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

124388 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124396 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

124408 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124426 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124434 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124451 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124503 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

124546 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124565 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124574 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124586 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

124590 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

124615 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

124616 Public Employee & Pension/Retiree 3/30/2021 Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124617 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124626 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124629 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124657 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124671 Public Employee & 

Pension/Retiree2 11/13/2020

Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 264 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

124674 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124692 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124698 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

124714 Public Employee & 

Pension/Retiree2 11/13/2020

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124731 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124763 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124771 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124773 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124777 Public Employee & 

Pension/Retiree2 7/2/2021 Commonwealth of Puerto Rico, Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

124791 Public Employee 3/30/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124797 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

124798 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124806 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

124848 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

124858 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

124866 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124868 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124890 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124934 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 265 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

124946 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124947 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124963 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 124965 Public Employee 3/30/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

124996 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 125067 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

125101 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 125146 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 125153 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 125159 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

125203 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 125243 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 125267 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

125275 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 125294 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

125324 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

125341 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

125343 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

125347 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 266 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

125366 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

125375 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 125382 Public Employee 5/4/2021 Department of Health (Jose N Gandara Hospital District) Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 125405 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 125412 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

125424 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

125458 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 125471 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 125476 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

125496 Public Employee 10/22/2020 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

125511 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 125512 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 125569 Public Employee 11/13/2020 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

125599 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 125600 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 125623 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 125658 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

125660 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

125705 Public Employee & Pension/Retiree 6/10/2021 Environmental Quality Board & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 267 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

125746 Public Employee 3/30/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

125753 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

125784 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

125788 Public Employee 3/30/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

125789 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

125818 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

125823 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

125934 Public Employee 12/20/2022 PR Police Bureau, PR Police Department Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 125989 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126013 Public Employee & Pension/Retiree2 5/4/2021 Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126025 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126038 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126039 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

126047 Public Employee 3/30/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126078 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126085 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126089 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126143 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health (WIC Program) Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126168 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 268 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

126188 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126202 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

126214 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126260 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126281 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

126289 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

126296 Public Employee & 

Pension/Retiree4 3/5/2021

Department of Labor and Human Resources, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126314 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126319 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126357 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126377 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

126464 Public Employee 5/4/2021 Department of Health (Guayama Area Hospital) Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126497 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126502 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126556 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126585 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126591 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126600 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

126601 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 269 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

126609 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126627 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126635 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126644 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126650 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126666 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

126675 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126682 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126696 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126710 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126752 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126756 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126759 Public Employee & 

Pension/Retiree2 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

126785 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126794 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126808 Public Employee 5/4/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126821 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126845 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126888 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 270 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

126892 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

126909 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126917 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126918 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126924 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126938 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

126942 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126944 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

126945 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

126946 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 126988 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

126997 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

127008 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 127018 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 127019 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

127046 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

127048 Pension/Retiree6 7/2/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

127089 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

127106 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 271 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

127124 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

127128 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

127135 Public Employee 3/30/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

127152 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 127156 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 127252 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 127258 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

127277 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

127307 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 127319 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

127329 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

127347 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

127428 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 127481 Public Employee 3/30/2021 Child Support Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

127506 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 127509 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 127538 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 127569 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 127584 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 272 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

127601 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

127605 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

127606 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

127607 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

127632 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 127660 Public Employee, Pension/Retiree & Union Grievance 6/10/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

127675 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

127689 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

127690 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 127697 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

127713 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 127736 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 127747 Public Employee 3/30/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

127776 Public Employee & Pension/Retiree 7/13/2021 Department of Housing, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

127777 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

127804 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

127828 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

127830 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

127843 Public Employee 3/30/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 273 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

127886 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Department of Social Services, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

127889 Pension/Retiree 11/6/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review7 

127901 Public Employee 5/4/2021 Department of Housing Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

127954 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

127984 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

127988 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

127992 Public Employee & 

Pension/Retiree4 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128030 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 128052 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

128066 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

128093 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 128144 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

128160 Public Employee 3/30/2021 Administration of Correction, Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 128192 Public Employee 5/4/2021 Administration of Youth Institutions Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128193 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128232 Public Employee 7/13/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128248 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128254 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128257 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 274 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

128280 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

128281 Public Employee 7/29/2022 Department of Education Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

128288 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 128318 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 128421 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128431 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

128441 Public Employee & Pension/Retiree 11/13/2020 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

128494 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

128499 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

128510 Public Employee & Pension/Retiree 6/10/2021 Department of Treasury Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

128515 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

128520 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

128524 Public Employee 3/30/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128550 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128557 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

128563 Public Employee & Pension/Retiree 3/30/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

128603 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 128612 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128670 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 275 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

128695 Public Employee & 

Pension/Retiree2 5/4/2021 Administration of Health Facilities and Services, Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

128712 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

128722 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128733 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128734 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128740 Public Employee 3/30/2021 Office of the OMBUDSMAN Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128748 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 128755 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

128767 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128770 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 128792 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128820 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 128835 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128836 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128860 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128952 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

128953 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 128968 Public Employee & Pension/Retiree 6/10/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 128998 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 276 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

129001 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

129010 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

129048 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

129093 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

129107 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 129141 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 129175 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 129177 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 129182 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

129191 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 129197 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

129210 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 129260 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

129279 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

129333 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

129339 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

129352 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

129359 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

129365 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education and Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 277 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

129410 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 129429 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 129434 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 129465 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

129473 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

129484 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

129505 Public Employee & Pension/Retiree 7/13/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 129520 Public Employee & 

Pension/Retiree2 5/4/2021 Services and Agricultural Development Administration Y N/A Y Y N/A N N/A 

129544 Public Employee & 

Pension/Retiree2 6/10/2021

Mental Health Services and Addiction Control Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

129562 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

129597 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

129627 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

129650 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

129659 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

129664 Public Employee 5/4/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

129821 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

129836 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

129859 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

129899 Public Employee & 

Pension/Retiree2 11/13/2020

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 278 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

129911 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

129941 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

129948 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

129954 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 129974 Public Employee 12/20/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 129984 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

129996 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130014 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130023 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130040 Public Employee & Pension/Retiree2 11/11/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

130074 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130080 Public Employee3 6/10/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130114 Public Employee & Pension/Retiree2 6/10/2021 Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130115 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130133 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

130143 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130154 Public Employee & Pension/Retiree 3/30/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130156 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130159 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 279 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

130169 Union Grievance 12/10/2021 Multiple Agencies Y N/A N N

Informal Information Request sent 

to claimant; response received and 

being reviewed.

N N/A 

130170 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130176 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130182 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130198 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

130219 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130247 Public Employee 5/4/2021 Administration of Health Facilities and Services, Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130263 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

130274 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

130305 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

130328 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

130339 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

130361 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

130384 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130402 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130421 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130428 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130429 Public Employee 11/13/2020 Department of Family, Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130431 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 280 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

130445 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130457 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130482 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130488 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130493 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130510 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130511 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130515 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130547 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130610 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130620 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130636 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

130646 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130661 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130690 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130702 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130730 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130758 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 281 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

130764 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130770 Public Employee 12/20/2022 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 130777 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130778 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130822 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

130834 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130865 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130934 Public Employee & Pension/Retiree 6/10/2021 Department of Labor and Human Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

130942 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130952 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130964 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130966 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 130969 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130981 Public Employee3 6/10/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131007 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 131110 Public Employee & Pension/Retiree 6/10/2021 Department of Treasury Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

131112 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131156 Public Employee & Pension/Retiree 3/30/2021 Mental Health Services and Addiction Control Administration, Office of the OMBUDSMAN - Women Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 282 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

131167 Public Employee & Pension/Retiree 3/30/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131212 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 131263 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 131270 Public Employee & Pension/Retiree 6/24/2022 Department of Education, Teachers Retirement System Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting response N N/A 

131277 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 131290 Public Employee & 

Pension/Retiree2 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131306 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131309 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131316 Public Employee3 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131326 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131332 Public Employee & Pension/Retiree 6/10/2021

Department of Natural and Environmental Resources, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131364 Pension/Retiree1 7/13/2021 Teachers Retirement System Y N/A Y Y N/A N N/A 

131371 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131376 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

131382 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

131400 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131402 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 131425 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

131478 Public Employee & Pension/Retiree 6/10/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 283 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

131480 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131491 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 131530 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

131546 Public Employee & 

Pension/Retiree2 3/30/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131564 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 131612 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131614 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131621 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 131635 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

131656 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 131663 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

131665 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

131701 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

131714 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131737 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131738 Public Employee & 

Pension/Retiree2 11/13/2020

Corps of Firefighters Bureau, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A N N/A 

131753 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 131761 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131785 Public Employee 7/29/2022 Department of Education Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 284 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

131795 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131809 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131812 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131838 Public Employee 5/4/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131845 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131886 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 131889 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131912 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131932 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 131933 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

131951 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 131957 Public Employee & Pension/Retiree 6/10/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

131958 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131962 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

131981 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

131998 Public Employee & Pension/Retiree2 5/4/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132050 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

132082 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

132086 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 285 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

132097 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132102 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

132110 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132111 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

132122 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

132147 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

132173 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

132180 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

132189 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132238 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132241 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

132246 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

132255 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132271 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

132273 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132283 Public Employee & Pension/Retiree 6/10/2021 Administration of Correction, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132309 Public Employee 1/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

132339 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132354 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 286 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

132383 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

132385 Public Employee & Pension/Retiree 6/10/2021 Corps of Firefighters Bureau, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132402 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

132414 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132438 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132475 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

132493 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Institute of Forensic Science Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

132525 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

132534 Public Employee & Pension/Retiree 7/13/2021 Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132536 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

132541 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

132584 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132586 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

132632 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132641 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132667 Public Employee & Pension/Retiree 6/10/2021 Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132695 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132721 Public Employee3 6/10/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

132736 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 287 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

132759 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

132797 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

132810 Public Employee 11/13/2020 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

132832 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132848 Public Employee 3/30/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

132853 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

132855 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

132884 Public Employee & Pension/Retiree 6/10/2021 Department of Agriculture, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132885 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

132888 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

132898 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 132900 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

132921 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

132961 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

132977 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133006 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

133041 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133065 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133079 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 288 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

133099 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133103 Public Employee 1/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133105 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133130 Public Employee & 

Pension/Retiree2 3/30/2021

Cooperative Development Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133136 Public Employee 12/20/2022 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 133137 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

133152 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

133162 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

133176 Public Employee & Pension/Retiree2 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133177 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133197 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133206 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

133250 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133287 Public Employee & Pension/Retiree 6/10/2021 Department of Housing, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133291 Public Employee 6/10/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133307 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133311 Public Employee 5/4/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133388 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

133393 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 289 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

133394 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

133425 Public Employee & Pension/Retiree 8/25/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133430 Public Employee & Pension/Retiree 3/30/2021

Department of Sports and Recreation & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133475 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133486 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133507 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

133516 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133517 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133526 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133530 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133533 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133535 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133537 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133556 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133576 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133587 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133620 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133627 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133648 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 290 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

133676 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133681 Public Employee, Pension/Retiree & Union Grievance 3/30/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133717 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133735 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

133738 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133745 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133749 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133779 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

133788 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133795 Public Employee & 

Pension/Retiree2 3/30/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133799 Pension/Retiree1 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

133818 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

133821 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133835 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133861 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133884 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133889 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

133910 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133959 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 291 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

133969 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133973 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133999 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

134040 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

134058 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

134060 Public Employee & Pension/Retiree2 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 134084 Public Employee 3/30/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

134132 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

134157 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 134175 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 134201 Public Employee & 

Pension/Retiree2 7/29/2022 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

134233 Public Employee & Pension/Retiree 3/30/2021

Department of Correction and Rehabilitation & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

134244 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

134254 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

134256 Public Employee & 

Pension/Retiree2 5/4/2021 National Parks of Puerto Rico, Recreational Development Comp Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

134285 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

134293 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

134320 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

134339 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 292 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

134376 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 134383 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 134409 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 134420 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

134456 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

134467 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 134468 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 134477 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

134483 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

134492 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 134514 Public Employee & Pension/Retiree 6/10/2021

Mental Health Services and Addiction Control Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

134531 Public Employee & Pension/Retiree 6/10/2021 Office of Court Administration, Puerto Rico Judicial Branch Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

134536 Public Employee 3/30/2021 Department of Sports and Recreation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

134561 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 134606 Public Employee & Pension/Retiree 6/10/2021 Department of Housing Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

134638 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

134646 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

134677 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 293 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

134695 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

134701 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

134710 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

134765 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 134882 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 134893 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

134896 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

134902 Public Employee 5/4/2021 Department of Housing Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

134916 Public Employee & Pension/Retiree 6/10/2021 Department of Housing Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

134958 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

134965 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

134969 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

134996 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

135037 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

135042 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 135061 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

135106 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

135120 Pension/Retiree1 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

135139 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 294 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

135170 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

135285 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

135286 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 135288 Public Employee & Pension/Retiree 6/24/2022 Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 135302 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 135337 Public Employee & Pension/Retiree2 7/2/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 135349 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 135385 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 135403 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

135410 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 135422 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

135456 Pension/Retiree 3/5/2021

Employees Retirement System of the 

Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

135462 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

135498 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 135511 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

135523 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

135530 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 135533 Public Employee 5/4/2021 Department of Housing Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

135588 Public Employee 3/30/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 295 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

135593 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

135717 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 135737 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

135743 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

135750 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

135808 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 135826 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

135845 Public Employee & Pension/Retiree 6/10/2021

Services and Agricultural Development Adminstration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

135863 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

135890 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

135927 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

135962 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

135983 Public Employee & Pension/Retiree 3/30/2021

Mental Health Services and Addiction Control Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136010 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136012 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136023 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136024 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136040 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136061 Public Employee & Pension/Retiree 3/30/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 296 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

136140 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 136141 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 136164 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 136165 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136183 Public Employee 5/4/2021 General Services Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136239 Public Employee 7/29/2022 Department of Education Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

136288 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136300 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136316 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136364 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136368 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 136432 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

136454 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

136478 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

136539 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

136547 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

136571 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

136597 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136610 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 297 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

136674 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 136679

Union Grievance & Pension/Retiree5 7/2/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136680 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 136681 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 136685 Public Employee & 

Pension/Retiree2 3/30/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136701 Public Employee 5/4/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136721 Public Employee 5/4/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136744 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 136754 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

136769 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136806 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 136825 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 136875 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136877 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136890 Public Employee & Pension/Retiree 6/10/2021 Administration of Correction, Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 136948 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 136949 Public Employee 5/4/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136950 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136964 Pension/Retiree 3/5/2021

Employees Retirement System of the 

Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 298 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

136974 Public Employee 5/4/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136975 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 137013 Public Employee 3/30/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137045 Public Employee & 

Pension/Retiree2 6/10/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137048 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137049 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137060 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137066 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

137078 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

137081 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 137109 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137123 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 137129 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137172 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137173 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 137196 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 137201 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137222 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137310 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 299 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

137345 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 137347 Public Employee 5/4/2021 Public Service Commission Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137352 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137381 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137390 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137398 Public Employee & Pension/Retiree 6/10/2021 Public Housing Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

137491 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

137496 Public Employee & Pension/Retiree 6/10/2021

Family and Children Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137518 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137532 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 137564 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

137579 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

137580 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Sports and Recreation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137586 Public Employee & Pension/Retiree 7/13/2021 Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

137608 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 137684 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 137699 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

137708 Public Employee 5/4/2021 Administration of Correction Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137762 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 300 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

137793 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

137794 Public Employee & Pension/Retiree 3/30/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 137809 Pension/Retiree 11/6/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review7 

137829 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

137835 Public Employee & Pension/Retiree 6/10/2021 Department of Housing Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

137857 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

137897 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

137911 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137936 Public Employee 5/4/2021 Corps of Medical Emergencies Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137965 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

137990 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 138007 Public Employee 5/4/2021 Administration of Correction, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 138046 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

138098 Public Employee & 

Pension/Retiree4 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

138127 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

138132 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

138135 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

138170 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

138178 Public Employee 7/29/2022 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 301 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

138179 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 138184 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 138193 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

138195 Public Employee & Pension/Retiree 6/10/2021 Office of Court Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 138256 Public Employee & Union Grievance 7/2/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

138299 Pension/Retiree 11/6/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

138321 Public Employee & Union Grievance 7/2/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

138353 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 138384 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

138395 Public Employee 5/4/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

138398 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

138401 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

138410 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

138415 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 138421 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 138432 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

138442 Public Employee3 7/13/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

138443 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

138456 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 302 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

138470 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 138475 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

138535 Public Employee 3/30/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

138559 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

138565 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

138606 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

138622 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 138704 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

138705 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

138738 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 138747 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 138755 Public Employee & Pension/Retiree 6/10/2021

Department of Labor and Human Resources & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

138765 Public Employee & Pension/Retiree 3/30/2021 Department of Housing & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 138811 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 138818 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

138855 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

138860 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

138875 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 138885 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 303 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

138893 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 138930 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

138976 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

139004 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 139008 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

139021 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139035 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

139063 Public Employee 5/4/2021 Department of Housing Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139107 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139136 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

139137 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 139207 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139287 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139289 Public Employee & Pension/Retiree 3/30/2021 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 139365 Public Employee & 

Pension/Retiree4 3/5/2021

Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139391 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

139410 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139421 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

139436 Public Employee 6/10/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 304 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

139467 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

139477 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

139486 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139490 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139498 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

139499 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 139514 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 139516 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

139599 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 139638 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139679 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 139682 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 139684 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

139686 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

139688 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139714 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139717 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 139739 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139743 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 305 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

139786 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 139842 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

139852 Public Employee 11/13/2020 General Services Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139858 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139880 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 139892 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139912 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139927 Public Employee 11/13/2020 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139951 Public Employee & Pension/Retiree 3/30/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

139988 Public Employee 11/13/2020 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139994 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

140019 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

140022 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140024 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140044 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

140046 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140091 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

140116 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

140121 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 306 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

140152 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140160 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140165 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

140179 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140181 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

140194 Public Employee & Pension/Retiree 11/11/2020 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

140207 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

140257 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

140277 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140290 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

140310 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140327 Public Employee & Pension/Retiree 6/10/2021 Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140357 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140367 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140440 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140544 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

140562 Public Employee & Pension/Retiree 6/10/2021 Department of Housing & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140572 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

140580 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 307 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

140604 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

140629 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Medical Assistance Program Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140646 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

140648 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

140655 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

140665 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140678 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

140704 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

140711 Public Employee 5/4/2021 Department of Family, Department of Social Services Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140731 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140733 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140748 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

140775 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140776 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140780 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

140793 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

140794 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

140836 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140849 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 308 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

140857 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

140858 Public Employee & Pension/Retiree 7/13/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 140897 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

140914 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

140916 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

140921 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

140959 Public Employee & Pension/Retiree 6/10/2021 Department of Treasury Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

141038 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 141045 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

141085 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

141115 Public Employee 3/30/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

141161 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

141174 Public Employee & Pension/Retiree 6/10/2021 Department of Housing Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

141181 Public Employee & Pension/Retiree 6/10/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 141213 Public Employee 5/4/2021 Hospital Regional Caguas Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

141233 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 141258 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

141304 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

141336 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 309 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

141350 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 141356 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

141367 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 141374 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

141384 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

141402 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

141433 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

141457 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

141508 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

141523 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 141528 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 141530 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

141547 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 141566 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

141606 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

141610 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

141626 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

141689 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 141690 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 310 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

141692 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 141713 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 141748 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

141756 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

141757 Public Employee 6/10/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

141770 Public Employee 3/30/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 141781 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 141782 Public Employee & Pension/Retiree 3/30/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 141821 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 141870 Public Employee & Pension/Retiree 7/13/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

141910 Public Employee 3/30/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

141923 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

141932 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

141934 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 141978 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

142003 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

142006 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

142016 Public Employee & Pension/Retiree 7/2/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

142026 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 311 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

142033 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142036 Public Employee 3/30/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

142076 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142084 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

142106 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

142117 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142129 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142139 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

142168 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142175 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

142202 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

142206 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142258 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142286 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

142287 Public Employee & Pension/Retiree 7/13/2021 Department of Labor and Human Resources, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142288 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

142298 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142314 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

142325 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 312 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

142330 Public Employee & Pension/Retiree 6/10/2021 Department of Health & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142366 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142401 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142410 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

142414 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

142415 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

142420 Public Employee & Pension/Retiree 6/24/2022

Department of Labor and Human Resources, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

142426 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

142442 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142474 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142488 Pension/Retiree 11/13/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

142504 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

142558 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142598 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

142609 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

142640 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142643 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142674 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142716 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 313 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

142744 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

142773 Public Employee & Pension/Retiree 6/10/2021 Department of Housing Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

142803 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142824 Public Employee 7/13/2021 Department of Education, General Services Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142865 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

142958 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142966 Public Employee 3/30/2021 Department of Health, Health Ponce Region AFASS Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142973 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

142977 Public Employee 5/4/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 142989 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143013 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 143029 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 143038 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143104 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143145 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143170 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

143182 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 143190 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143215 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 314 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

143225 Public Employee & Pension/Retiree 6/10/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

143233 Public Employee & Pension/Retiree 7/2/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143238 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

143274 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

143277 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143295 Public Employee 5/4/2021 Permits Management Office Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143324 Public Employee 5/4/2021 Office of Court Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143349 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143362 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143389 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 143390 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 143391 Public Employee 5/4/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143396 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143404 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 143410 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143416 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

143443 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 143454 Public Employee 7/2/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143460 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 315 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

143461 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143485 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 143505 Public Employee & Pension/Retiree 6/10/2021

Department of Labor and Human Resources, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143528 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 143547 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 143563 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 143564 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143568 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 143588 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143630 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143677 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 143690 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143693 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

143721 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

143724 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

143733 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

143743 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

143753 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

143754 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 316 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

143767 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 143768 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

143774 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

143778 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143813 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Department of State, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 143830 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

143849 Public Employee & Pension/Retiree 7/13/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 143852 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

143854 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143855 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

143870 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143871 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143882 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 143891 Public Employee & Pension/Retiree 6/10/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

143906 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143916 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 143918 Public Employee & 

Pension/Retiree2 11/13/2020

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143934 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143993 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 317 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

144002 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 144016 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144020 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144058 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 144059 Pension/Retiree1 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

144064 Public Employee 7/29/2022 Vocational Rehabilitation Administration Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

144085 Public Employee 12/20/2022 Administration of Correction Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 144092 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144138 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

144142 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144190 Public Employee 3/30/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144191 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144194 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144221 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 144262 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144268 Public Employee & Pension/Retiree 6/10/2021 Department of Treasury Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

144280 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144286 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144299 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 318 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

144305 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

144322 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 144323 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

144347 Public Employee 3/30/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144445 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144448 Public Employee 5/4/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144450 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144451 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144460 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144493 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

144516 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144524 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144597 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 144607 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 144633 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144637 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 144676 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

144688 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 144692 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 319 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

144715 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 144723 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144725 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

144746 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144790 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

144811 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144829 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

144849 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 144851 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 144866 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144876 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 144882 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

144890 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144891 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144896 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 144936 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

144937 Public Employee & 

Pension/Retiree4 3/30/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

144976 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 144984 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 320 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

145019 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 145020 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

145024 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

145119 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 145129 Public Employee 7/29/2022 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145141 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 145150 Public Employee 5/4/2021 Department of Housing Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145154 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145188 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145189 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145190 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145206 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145207 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145208 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145262 Public Employee & Pension/Retiree 3/30/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

145266 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145282 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145304 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145332 Public Employee 11/13/2020 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 321 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

145333 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

145357 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

145364 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145369 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

145408 Public Employee3 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

145423 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 145482 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 145516 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145517 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 145522 Public Employee 5/4/2021 Recreational Development Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145541 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145552 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145574 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 145580 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

145581 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 145611 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145614 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 145635 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

145642 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 322 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

145655 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145670 Public Employee & Pension/Retiree 6/10/2021 Department of Treasury Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

145671 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 145695 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145699 Public Employee & Pension/Retiree 10/22/2020 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

145712 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145721 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145725 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 145744 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

145748 Public Employee & Pension/Retiree 6/10/2021 Department of Treasury Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

145767 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 145774 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145780 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

145791 Public Employee & 

Pension/Retiree2 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145816 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145838 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 145843 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145850 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145881 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 323 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

145894 Public Employee & 

Pension/Retiree4 11/11/2020

Department of Education and Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145919 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 145931 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 145947 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

145979 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145988 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 145992 Public Employee 5/4/2021 Public Housing Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

146044 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

146060 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

146078 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

146109 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 146143 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 146147 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 146151 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 146152 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 146172 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

146173 Public Employee & Pension/Retiree 6/10/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

146182 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

146212 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 324 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

146213 Public Employee & Pension/Retiree2 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 146219 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

146271 Public Employee 5/4/2021 Department of Housing Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

146286 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

146301 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 146342 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

146343 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

146349 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

146354 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 146383 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

146386 Public Employee 5/4/2021 Department of Housing Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

146483 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

146505 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 146511 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

146522 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

146543 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

146592 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

146594 Public Employee & Pension/Retiree 3/30/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

146596 Public Employee 3/30/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 325 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

146597 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

146607 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

146684 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

146689 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

146708 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

146734 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

146783 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

146802 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 146839 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

146842 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

146849 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

146855 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

146860 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

146862 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

146871 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

146882 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 146937 Public Employee 6/10/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

146991 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 147055 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 326 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

147081 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

147084 Public Employee & Pension/Retiree 6/10/2021 Department of Treasury & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 147087 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 147099 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

147100 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

147144 Public Employee & Pension/Retiree 6/10/2021

Department of Health, Family Health Center, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

147201 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

147215 Public Employee & Pension/Retiree 6/10/2021 Department of Labor and Human Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

147217 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 147235 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 147264 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 147269 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 147291 Public Employee & Pension/Retiree 6/10/2021

Mental Health Services and Addiction Control Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

147295 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

147343 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

147410 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

147423 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

147450 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 147464 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 327 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

147496 Public Employee 5/4/2021 Corps of Medical Emergencies Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

147531 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

147554 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

147569 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

147581 Public Employee & Pension/Retiree 6/10/2021 Public Housing Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 147585 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

147593 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

147617 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Justice Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

147622 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

147665 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

147677 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 147683 Public Employee & Pension/Retiree 6/10/2021 Department of Housing Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

147721 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

147739 Public Employee 12/20/2022 Administration of Correction Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 147741 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 147778 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 147805 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

147811 Public Employee & Pension/Retiree 3/30/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

147855 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 328 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

147857 Public Employee & 

Pension/Retiree2 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

147864 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

147877 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 147886 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

147909 Public Employee & Pension/Retiree 3/30/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 147917 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

147952 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148000 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

148004 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148039 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148045 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148063 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

148074 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148084 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148092 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148118 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148128 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148136 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148168 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 329 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

148169 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148195 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

148212 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148221 Public Employee 3/30/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148227 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148310 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148313 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148404 Public Employee 11/11/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148413 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148420 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148421 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148428 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148437 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148458 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148463 Public Employee & Pension/Retiree 6/10/2021

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148544 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148546 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148565 Public Employee & Pension/Retiree 6/10/2021 Department of Justice Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 330 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

148569 Public Employee 6/10/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148606 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148618 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148650 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148666 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148673 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148683 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

148696 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

148707 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

148718 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148772 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148804 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148809 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148813 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148821 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148852 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148858 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148864 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148871 Public Employee & Pension/Retiree 3/30/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 331 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

148882 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148896 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148901 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education and Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

148943 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148945 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148952 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

148957 Public Employee & Pension/Retiree 7/13/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 148967 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

149039 Public Employee 12/20/2022 Administration of Correction Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

149061 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 149066 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 149072 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

149103 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

149106 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

149122 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

149131 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 149152 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

149162 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

149167 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 332 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

149175 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

149203 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

149231 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 149239 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 149265 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

149282 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 149302 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

149356 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

149366 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

149375 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Economic Development and Commerce Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

149385 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

149405 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

149426 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 149449 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 149470 Public Employee 11/13/2020 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

149476 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 149512 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

149530 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 149537 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 333 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

149546 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 149555 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

149557 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

149584 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 149593 Public Employee & Pension/Retiree 6/10/2021 Department of Labor and Human Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

149600 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 149645 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 149659 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

149661 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 149685 Public Employee & Pension/Retiree 7/13/2021 Program of Youth Affairs & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 149804 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

149844 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

149885 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

149902 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

149907 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 149945 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 149951 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

149959 Public Employee & Union Grievance 6/10/2021 Child Support Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

149967 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 334 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

149980 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

149982 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 150056 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

150072 Public Employee & Pension/Retiree 6/10/2021 Department of Health & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 150079 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

150080 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 150081 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150108 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150116 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

150125 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150192 Public Employee & Pension/Retiree 3/30/2021

Mental Health Services and Addiction Control Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150205 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 150208 Public Employee & Pension/Retiree 6/10/2021 Department of Housing Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

150216 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 150228 Public Employee3 6/10/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150249 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

150254 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 150255 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150265 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 335 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

150298 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

150300 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150306 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150337 Public Employee & Pension/Retiree 3/30/2021 Department of Health & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 150352 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150359 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150360 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150378 Public Employee 5/4/2021 Department of Housing Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150386 Public Employee 6/10/2021 Department of Social Services Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150390 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150398 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150410 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150417 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 150423 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150454 Public Employee & 

Pension/Retiree2 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

150458 Public Employee & Pension/Retiree 6/10/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

150459 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150461 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150462 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 336 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

150488 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 150500 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150525 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

150533 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

150535 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 150544 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

150545 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 150589 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 150626 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150665 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 150670 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

150675 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 150682 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150715 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 150717 Public Employee 5/4/2021

Office of Administration and Transformation of Human Resources in the Government of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150744 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150798 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 150804 Public Employee 5/4/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150810 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 337 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

150818 Public Employee & Pension/Retiree 11/11/2020 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

150821 Public Employee & Pension/Retiree 6/10/2021 Department of Treasury Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

150827 Public Employee & Pension/Retiree 11/13/2020 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

150840 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150841 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150858 Public Employee & Pension/Retiree 6/10/2021 Department of Labor and Human Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

150895 Public Employee & 

Pension/Retiree2 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150936 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 150969 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 150988 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

150990 Pension/Retiree6 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

151002 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151057 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 151058 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151059 Public Employee 6/10/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151067 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 151071 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 151078 Public Employee & Pension/Retiree 6/10/2021

Socioeconomic Development of the Family Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151107 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 338 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

151139 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 151151 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151179 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151180 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151210 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151213 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151225 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151238 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

151261 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

151273 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 151333 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151353 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 151366 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151395 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151400 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 151416 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 151440 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151441 Public Employee & Pension/Retiree 6/10/2021 Senate, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 151453 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 339 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

151466 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 151497 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

151519 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151522 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 151523 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 151528 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 151537 Public Employee 5/4/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151542 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 151599 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151600 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151622 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

151660 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151688 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 151766 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151805 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 151807 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

151843 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

151860 Public Employee & Pension/Retiree 6/10/2021 Public Building Authority Y N/A Y Y N/A N N/A 151883 Public Employee 7/2/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 340 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

151884 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

151895 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

151910 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

151912 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 151933 Public Employee & Pension/Retiree 7/13/2021

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151950 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

151983 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

152046 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

152049 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 152128 Public Employee 11/11/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

152186 Public Employee & Pension/Retiree 6/10/2021 Department of Justice, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 152190 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

152193 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

152198 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

152214 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

152220 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 152252 Public Employee 6/10/2021 Department of Family, Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 152256 Public Employee & Pension/Retiree 6/10/2021 Department of Housing Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

152270 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 341 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

152282 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 152301 Public Employee 3/30/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

152319 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

152336 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 152354 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

152355 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

152359 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

152378 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 152396 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 152431 Public Employee 3/30/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

152436 Public Employee & Union Grievance 7/29/2022 Department of Health Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

152440 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

152463 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

152474 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

152504 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

152506 Public Employee & Pension/Retiree 1/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 152569 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

152575 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

152577 Public Employee & Pension/Retiree 3/30/2021 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 342 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

152605 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

152673 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 152677 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 152704 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 152725 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

152736 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Housing & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

152764 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

152765 Public Employee3 6/10/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

152773 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 152789 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 152805 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

152806 Public Employee 5/4/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 152815 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

152827 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

152859 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

152868 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

152916 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 152940 Public Employee & 

Pension/Retiree2 11/13/2020

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

152950 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 343 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

152951 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

152974 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

153014 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

153073 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 153076 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153136 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153179 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 153186 Public Employee & Pension/Retiree2 7/2/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 153205 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

153211 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153217 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 153232 Public Employee 5/4/2021 Public Service Appellate Commission Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153245 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153286 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

153290 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153298 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

153309 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

153318 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 344 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

153322 Public Employee & Pension/Retiree 6/10/2021 Highway and Transportation Authority Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

153327 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153329 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

153334 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

153341 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

153352 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 153353 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

153365 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

153386 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 153391 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153400 Public Employee3 3/30/2021 Corporation Urban Renewal and Housing (CRUV), Department of Housing Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

153405 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153447 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

153451 Public Employee & Pension/Retiree 6/10/2021

Department of Labor and Human Resources, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153452 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153453 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 153458 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 153462 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

153466 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 345 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

153467 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153470 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

153500 Public Employee 6/10/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153527 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

153551 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 153554 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 153562 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153574 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

153577 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 153588 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 153591 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153614 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153621 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 153629 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

153636 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 153692 Public Employee & 

Pension/Retiree2 6/10/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

153703 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153720 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

153746 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 346 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

153763 Public Employee & Pension/Retiree 6/10/2021 Department of Treasury Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

153785 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153789 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 153821 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 153855 Public Employee 6/10/2021

Administration of Health Facilities and Services, Deparment of Health AFASS Health Ponce Region

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153860 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

153878 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153901 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

153941 Public Employee & Pension/Retiree 10/22/2020 Department of Health & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

154026 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

154030 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 154064 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 154073 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154086 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154097 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154098 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154117 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154135 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154155 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 347 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

154164 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154191 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 154214 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 154219 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154222 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review7 

154234 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

154242 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154309 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 154315 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154332 Public Employee & Pension/Retiree 6/10/2021 Department of Housing Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

154334 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

154336 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154346 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

154347 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154363 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154416 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

154438 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 154469 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

154480 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 348 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

154506 Public Employee 12/20/2022

Department of Family, Family and Children Administration, Vocational Rehabilitation Administration

Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

154524 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 154542 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 154576 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154586 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 154617 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

154619 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

154624 Public Employee & Pension/Retiree 3/30/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

154625 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154644 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154654 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 154666 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

154671 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

154707 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154717 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154740 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 154871 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 154882 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154938 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 349 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

154941 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154953 Pension/Retiree 11/11/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

154956 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

154976 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154978 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155008 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 155022 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155043 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

155053 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

155065 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 155095 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155105 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

155120 Public Employee 6/24/2022 Department of Transportation and Public Works, Driver Services Center Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

155122 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155135 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155162 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155219 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155267 Public Employee & Pension/Retiree 6/10/2021

Department of Health, Family Health Center, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155292 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 350 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

155307 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155329 Public Employee 5/4/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155349 Public Employee 11/13/2020 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155352 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155396 Public Employee 5/4/2021 Department of Sports and Recreation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155398 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 155399 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155443 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

155470 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155487 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155506 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

155507 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155544 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155559 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 155584 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155589 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 155592 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

155607 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155629 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 351 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

155639 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155678 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155699 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155706 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 155718 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155727 Public Employee & Pension/Retiree2 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 155758 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

155798 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 155844 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 155866 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155881 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 155923 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155927 Public Employee & 

Pension/Retiree2 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155949 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 155952 Public Employee & Pension/Retiree 3/30/2021 Department of Health (AFASS Health Ponce Region) Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 155980 Public Employee & Pension/Retiree 7/13/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

155994 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 156000 Public Employee & Pension/Retiree 6/10/2021 Public Building Authority Y N/A Y Y N/A N N/A 156018 Public Employee & Pension/Retiree 6/10/2021 Public Housing Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 352 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

156053 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

156059 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

156065 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

156068 Public Employee3 6/10/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

156093 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

156115 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 156141 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

156147 Public Employee & Pension/Retiree 6/10/2021

Department of Transportation and Public Works, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

156185 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

156208 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

156209 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 156219 Public Employee & 

Pension/Retiree2 6/10/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

156223 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

156241 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

156246 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

156284 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

156299 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 156311 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

156346 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 353 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

156362 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

156374 Public Employee & Pension/Retiree 6/10/2021 Administration of Health Facilities and Services, Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 156397 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 156424 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 156438 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

156449 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 156465 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 156472 Public Employee & Pension/Retiree 3/30/2021 Department of Health (Ponce Region - Hospital San Lucas), WIC PROGRAM Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 156500 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

156513 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 156515 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

156539 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

156583 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

156661 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 156685 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

156734 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

156742 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

156764 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

156774 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 354 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

156776 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 156777 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

156806 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

156815 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

156863 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

156869 Public Employee 7/29/2022 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

156896 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

156921 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 156941 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

157000 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157080 Public Employee 6/10/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157087 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 157089 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157127 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

157133 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157155 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157170 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

157199 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 355 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

157200 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157204 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157205 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157211 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 157217 Public Employee 6/10/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157225 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157272 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 157298 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157302 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157319 Public Employee & Pension/Retiree 3/30/2021 Childcare and Childhood Integral Development Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 157374 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

157413 Public Employee 5/4/2021 Corps of Medical Emergencies Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157443 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 157445 Public Employee & Pension/Retiree2 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 157460 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157466 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 157494 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157516 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157542 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Housing Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 356 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

157543 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157583 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 157632 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157637 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 157647 Public Employee 5/4/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157667 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157669 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

157672 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157716 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157736 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157737 Public Employee 12/20/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

157752 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 157775 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157799 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157824 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157834 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 157837 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157855 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

157888 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 357 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

157920 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157946 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157974 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 157980 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 157998 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

158007 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

158036 Public Employee, Pension/Retiree & Union Grievance 6/10/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

158042 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

158046 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

158065 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

158073 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

158087 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158097 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158102 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

158111 Public Employee & Pension/Retiree 6/10/2021 Department of Family, Department of Social Services Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158116 Public Employee 11/13/2020 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

158122 Public Employee3 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

158152 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

158191 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 358 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

158201 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

158205 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

158208 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

158226 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

158229 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158245 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

158251 Public Employee3 6/10/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

158299 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158326 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

158333 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158339 Public Employee 5/4/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158365 Public Employee & Pension/Retiree 3/30/2021 Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158384 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

158404 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158413 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

158415 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

158420 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

158433 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

158450 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 359 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

158483 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158488 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158533 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158558 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

158561 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

158612 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

158622 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158663 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158669 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158723 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158788 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158791 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

158844 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

158848 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

158853 Public Employee & Pension/Retiree 3/30/2021 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158900 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158904 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

158927 Public Employee 6/10/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

158931 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 360 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

158933 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 158949 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

158957 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

158970 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159008 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159025 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 159050 Public Employee 6/10/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 159059 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159103 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 159110 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

159112 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159125 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

159162 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159191 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

159193 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159283 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159284 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 159302 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 159316 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 361 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

159323 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159327 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

159334 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159352 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159353 Public Employee 5/4/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 159354 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159360 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159380 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 159421 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 159486 Pension/Retiree 12/20/2022

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A N N/A 

159505 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 159519 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159543 Public Employee & Pension/Retiree 11/13/2020

Department of Labor and Human Resources & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159556 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159588 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159594 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

159601 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

159606 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159607 Public Employee & 

Pension/Retiree2 5/4/2021 Public Building Authority Y N/A Y Y N/A N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 362 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

159620 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159632 Public Employee 6/10/2021 Corporation Urban Renewal and Housing (CRUV), Department of Housing Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 159654 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

159659 Public Employee & Pension/Retiree 6/10/2021

Department of Health, Family Health Center, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159661 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 159681 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159706 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

159750 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

159770 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

159776 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 159781 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159792 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159829 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

159863 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159889 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159908 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

159917 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 159956 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 160011 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 363 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

160035 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160055 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

160059 Public Employee 3/30/2021

Office of Administration and Transformation of Human Resources in the Government of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160062 Public Employee & Pension/Retiree 3/30/2021

Socioeconomic Development of the Family Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160067 Public Employee & Pension/Retiree 6/10/2021

Department of Health, Family Health Center, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160068 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160082 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160085 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 160096 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160122 Public Employee3 6/10/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160132 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160162 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 160171 Public Employee & Pension/Retiree 6/10/2021

Department of Labor and Human Resources & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160195 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 160196 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160209 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160211 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

160215 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

160219 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 364 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

160237 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 160238 Public Employee 11/13/2020 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160243 Public Employee 10/22/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160245 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160281 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

160302 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 160310 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

160325 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 160401 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160404 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

160451 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160498 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160512 Public Employee & 

Pension/Retiree4 3/5/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

160514 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 160589 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 160623 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160656 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

160681 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160693 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 365 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

160707 Public Employee 6/10/2021 Department of Health (AFFAS) Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160719 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160749 Public Employee & Pension/Retiree 6/10/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

160754 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

160755 Public Employee & Pension/Retiree 3/30/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 160764 Public Employee 5/4/2021 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160771 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

160801 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160805 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160836 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

160899 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160904 Public Employee 3/30/2021 General Court of Justice Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160905 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 160921 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 160930 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 160980 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 160997 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

161001 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161012 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 366 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

161020 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161026 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161028 Public Employee & Pension/Retiree 6/10/2021 Department of Housing, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161045 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161053 Public Employee & Pension/Retiree 3/30/2021

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161054 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161063 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Labor and Human Resources, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161064 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

161069 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161088 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161118 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

161124 Pension/Retiree 11/6/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review7 

161188 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

161211 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161222 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

161267 Public Employee 5/4/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161277 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

161280 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

161289 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 367 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

161306 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

161317 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161326 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161327 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

161329 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161330 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

161336 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161339 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161343 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161391 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161424 Public Employee 5/4/2021

Department of Sports and Recreation, National Parks of Puerto Rico, Recreational Development Company

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161428 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161436 Public Employee3 6/10/2021 Department of Correction and Rehabilitation, Administration of Correction Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

161437 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161447 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161449 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161496 Public Employee & 

Pension/Retiree2 3/30/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161514 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161521 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 368 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

161555 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161561 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161588 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

161606 Public Employee 11/13/2020 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161615 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

161634 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161700 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161715 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161719 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161750 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161762 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161793 Public Employee & 

Pension/Retiree2 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161800 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

161805 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161810 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

161839 Public Employee & Pension/Retiree 6/10/2021 Department of Health & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161861 Public Employee 12/20/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 161896 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 161931 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 369 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

161963 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

161980 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

162005 Public Employee & 

Pension/Retiree2 7/2/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

162037 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

162044 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

162076 Public Employee & Pension/Retiree 10/22/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

162106 Public Employee & Pension/Retiree2 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162107 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162119 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

162125 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

162132 Pension/Retiree 11/6/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

162139 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162164 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

162171 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

162189 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162192 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

162204 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

162225 Public Employee 12/20/2022 PR Police Bureau, PR Police Department Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 162227 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 370 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

162244 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

162254 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162273 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162276 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162295 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

162296 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

162323 Public Employee & Pension/Retiree 7/13/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162326 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162388 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

162409 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

162412 Public Employee & Pension/Retiree2 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162427 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

162480 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162496 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

162529 Public Employee 5/4/2021 Department of Justice Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

162535 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

162538 Public Employee 6/10/2021 Department of Health, Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162582 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162586 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 371 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

162624 Public Employee & Pension/Retiree 7/13/2021 Department of Health & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162648 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162675 Pension/Retiree 11/6/2020

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review7 

162679 Public Employee 7/13/2021 Department of Education Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

162709 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162717 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

162745 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

162784 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

162790 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

162823 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

162831 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

162870 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162899 Public Employee & Pension/Retiree 6/10/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162904 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162915 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162925 Public Employee & Pension/Retiree 11/13/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

162926 Public Employee & Pension/Retiree 11/13/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

162945 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 162962 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 372 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

163009 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 163019 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163054 Public Employee & Pension/Retiree 6/10/2021 Administration of Correction Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

163094 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 163145 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 163153 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 163174 Public Employee & Pension/Retiree 6/10/2021 Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 163188 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163205 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 163228 Public Employee 5/4/2021 Senate Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163240 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 163300 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

163307 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

163330 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163333 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163345 Public Employee, Pension/Retiree & Union Grievance 6/10/2021 Office of Court Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

163361 Public Employee & Pension/Retiree 11/11/2020 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

163423 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163426 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 373 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

163483 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

163493 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

163522 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163531 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163580 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163586 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 163602 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163626 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163649 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163666 Public Employee & Pension/Retiree 3/30/2021

Vocational Rehabilitation Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163709 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163749 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163784 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 163822 Public Employee 5/4/2021 Department of Social Services, Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 163869 Public Employee & 

Pension/Retiree2 11/13/2020

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163870 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 163908 Public Employee 6/24/2022 Department of Family Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

163932 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163972 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 374 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

163978 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

164018 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 164047 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164056 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164069 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 164077 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

164079 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

164083 Public Employee 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 164089 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 164091 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164099 Public Employee & 

Pension/Retiree2 5/4/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164102 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

164108 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 164120 Public Employee & 

Pension/Retiree2 5/4/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164142 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164182 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

164202 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

164262 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164263 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 375 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

164293 Public Employee & Pension/Retiree2 7/2/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 164306 Public Employee 3/30/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164313 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164322 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 164342 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164346 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Justice Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164356 Public Employee 5/4/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164385 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164397 Public Employee & Pension/Retiree 6/10/2021 Department of Family, Department of Social Services Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 164465 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 164468 Public Employee 6/10/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164512 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164527 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164529 Public Employee & Pension/Retiree 6/10/2021 Public Building Authority, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 164581 Public Employee 12/20/2022 Department of Correction & Rehabilitation, Administration of Youth Institutions Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

164616 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164632 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164651 Public Employee 5/4/2021 Administration of Youth Institutions Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164672 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 376 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

164692 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164699 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164700 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 164703 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 164708 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164749 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 164786 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

164796 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164809 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

164853 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 164854 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

164861 Public Employee & Pension/Retiree 7/29/2022 Department of Education, Teachers Retirement System Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting response N N/A 

164894 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

164932 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 165045 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

165051 Public Employee & Pension/Retiree 6/10/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 165053 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

165086 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 165095 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 377 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

165152 Public Employee 3/30/2021 Administration of Correction Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

165175 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

165176 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

165204 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

165210 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

165223 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

165244 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

165291 Public Employee & Pension/Retiree 7/13/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 165307 Public Employee & Pension/Retiree 7/2/2021 Department of Housing Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

165311 Public Employee & 

Pension/Retiree4 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

165331 Public Employee & Pension/Retiree 3/30/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

165334 Public Employee & 

Pension/Retiree2 6/10/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

165347 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

165375 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

165386 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

165437 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

165499 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

165503 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

165507 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 378 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

165538 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 165551 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

165567 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

165573 Public Employee & Pension/Retiree 6/10/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

165574 Public Employee 6/10/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

165594 Public Employee & Pension/Retiree 3/30/2021 Administration of Correction, Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 165615 Public Employee 11/13/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

165646 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

165700 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 165728 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 165751 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

165775 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 165839 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

165869 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 165874 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

165901 Public Employee 3/30/2021 Administration of Correction Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

165990 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 166034 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

166057 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 379 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

166085 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

166152 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 166170 Public Employee 5/4/2021 Public Housing Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

166180 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

166212 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

166251 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

166260 Public Employee3 6/10/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

166272 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

166290 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

166307 Public Employee 6/10/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 166336 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

166423 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

166426 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

166443 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

166450 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 166455 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

166505 Public Employee, Pension/Retiree & Union Grievance 3/30/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

166523 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

166544 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 380 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

166546 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

166552 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 166576 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 166588 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

166592 Public Employee & Pension/Retiree 6/10/2021

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

166619 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

166630 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 166651 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

166653 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

166725 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 166728 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 166751 Public Employee 3/30/2021 Department of Agriculture Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

166763 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 166797 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 166848 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 166850 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

166880 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 166912 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 166958 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 381 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

167006 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167029 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167045 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 167083 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 167095 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 167109 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167111 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167118 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 167122 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

167129 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

167145 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 167153 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 167161 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167171 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167180 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

167186 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167214 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 167221 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

167239 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 382 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

167246 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167252 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

167253 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 167257 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167266 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 167276 Public Employee & Pension/Retiree 11/11/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

167279 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

167287 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167291 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167313 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 167317 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167347 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

167378 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167384 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 167392 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

167419 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167473 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167490 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167506 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 383 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

167520 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

167551 Public Employee & Pension/Retiree 3/30/2021 Department of Health & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 167591 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167604 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 167607 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 167619 Public Employee & Pension/Retiree 6/10/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

167635 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico, Teachers Retirement System

Y N/A Y Y N/A Y In Process/Under Review 

167645 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167686 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 167720 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167736 Public Employee 11/11/2020 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167740 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167741 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167743 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167750 Public Employee 5/4/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167756 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

167770 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167799 Public Employee3 6/10/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167813 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 384 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

167833 Public Employee 5/4/2021 Department of Agriculture Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167835 Public Employee 6/10/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167836 Public Employee 6/10/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167837 Public Employee & Pension/Retiree 6/10/2021 Department of Labor and Human Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

167874 Public Employee 7/2/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167897 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167916 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167924 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 167937 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

167942 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 167969 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 167974 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

167995 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

167996 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

168017 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

168029 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

168030 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

168066 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 168082 Public Employee & Pension/Retiree 6/10/2021 Child Support Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 385 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

168093 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

168104 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

168114 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 168115 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 168118 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 168120 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 168125 Public Employee 5/4/2021 Department of Correction Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

168131 Public Employee & Pension/Retiree 6/10/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

168132 Public Employee & Pension/Retiree 6/10/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

168136 Public Employee & Pension/Retiree 6/10/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

168139 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

168149 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

168152 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

168154 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

168174 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

168196 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

168349 Public Employee 6/10/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 168370 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 168401 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 386 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

168436 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 168464 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

168525 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

168536 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

168590 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

168620 Public Employee & Pension/Retiree 11/11/2020 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

168645 Pension/Retiree1 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

168832 Public Employee & 

Pension/Retiree2 1/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

168967 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

168983 Public Employee & Pension/Retiree 6/10/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 169005 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

169034 Public Employee & Pension/Retiree 3/30/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 169036 Public Employee 5/4/2021 Department of Health, Department of Health - Ponce Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 169061 Pension/Retiree6 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

169067 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

169334 Public Employee 5/4/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

169362 Pension/Retiree1 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

169524 Public Employee & Pension/Retiree 10/22/2020 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

169525 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 387 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

169554 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 169568 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 169600 Public Employee 3/30/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 169602 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

169603 Public Employee & 

Pension/Retiree2 5/4/2021

Office of the OMBUDSMAN, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

169604 Public Employee & 

Pension/Retiree2 7/2/2021

Office of the OMBUDSMAN, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

169620 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

169642 Pension/Retiree 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

169655 Public Employee 3/30/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 169656 Pension/Retiree6 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

169674 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

169676 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 169689 Public Employee & 

Pension/Retiree2 3/30/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

169694 Public Employee & Pension/Retiree 6/10/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 169711 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

169733 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

169760 Public Employee & 

Pension/Retiree2 3/30/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

169766 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

169767 Public Employee & 

Pension/Retiree2 3/30/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 388 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

169779 Public Employee 7/2/2021 Department of Education Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

169795 Public Employee & 

Pension/Retiree2 1/4/2021

Department of Agriculture & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

169803 Public Employee, Pension/Retiree & Union Grievance 1/4/2021 Department of Agriculture & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 169807 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

169824 Public Employee & Pension/Retiree 6/10/2021 Department of Labor and Human Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

169827 Public Employee 5/4/2021 Department of Family, Department of Social Services Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 169858 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

169889 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

169906 Pension/Retiree6 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

169907 Public Employee, Pension/Retiree & Union Grievance 1/4/2021 Department of Agriculture & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

169921 Public Employee, Pension/Retiree & Union Grievance 3/30/2021 Department of Agriculture & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 169925 Public Employee 5/4/2021 Department of Agriculture Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

169938 Public Employee, Pension/Retiree & Union Grievance 1/4/2021 Department of Agriculture & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 169955 Public Employee, Pension/Retiree & Union Grievance 3/30/2021 Department of Agriculture & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 169982 Public Employee, Pension/Retiree & Union Grievance 3/30/2021 Department of Agriculture & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 169984 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Agriculture & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

169986 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170000 Public Employee 5/4/2021 Department of Agriculture Y N/A Y Y N/A N N/A 170019 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 389 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

170025 Pension/Retiree1 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

170031 Public Employee, Pension/Retiree & Union Grievance 3/30/2021 Transportation and Public Works & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

170039 Public Employee 5/4/2021 Department of Agriculture Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170044 Public Employee, Pension/Retiree & Union Grievance 3/30/2021 Department of Agriculture & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170045 Public Employee, Pension/Retiree & Union Grievance 3/30/2021 Department of Agriculture & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170059 Pension/Retiree6 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

170060 Public Employee & Pension/Retiree 1/4/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

170062 Public Employee 5/4/2021 Department of Agriculture Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170070 Public Employee & Pension/Retiree 6/10/2021 Administration for Agricultural Business Development, Department of Agriculture Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170081 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170110 Public Employee & Pension/Retiree 6/10/2021

Services and Agricultural Development Adminstration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170113 Public Employee 5/4/2021 Services and Agricultural Development Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170119 Public Employee 1/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170120 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170131 Public Employee & Pension/Retiree 6/10/2021 Department of Agriculture Y N/A Y Y N/A N N/A 170135 Public Employee & Pension/Retiree 6/10/2021 Department of Agriculture & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170142 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170143 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170144 Public Employee 5/4/2021 Services and Agricultural Development Adminstration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 390 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

170146 Public Employee 5/4/2021 Office of the Ombudsman for the Elderly Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170166 Public Employee 5/4/2021 Department of Agriculture Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170167 Pension/Retiree6 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

170174 Public Employee & Pension/Retiree 6/10/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

170188 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170189 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170208 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170234 Pension/Retiree6 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

170249 Public Employee & Pension/Retiree2 5/4/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

170255 Public Employee & Pension/Retiree 6/10/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170256 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

170257 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170269 Public Employee & Pension/Retiree 3/30/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170272 Public Employee & Pension/Retiree 5/4/2021 Department of Treasury Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

170273 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170281 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170283 Public Employee & Pension/Retiree 6/10/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

170296 Public Employee & Pension/Retiree 6/10/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

170299 Public Employee & 

Pension/Retiree2 5/4/2021 Services and Agricultural Development Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 391 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

170308 Public Employee & Pension/Retiree2 5/4/2021

Services and Agricultural Development Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170317 Public Employee & Pension/Retiree 6/10/2021 Department of Agriculture, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A Y Y N/A N N/A 

170331 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170348 Public Employee & 

Pension/Retiree2 6/10/2021

Services and Agricultural Development Adminstration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170352 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170356 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170370 Public Employee 5/4/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170374 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170378 Public Employee & Pension/Retiree 6/10/2021 Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

170382 Public Employee 5/4/2021 Department of Agriculture Y N/A Y Y N/A N N/A 170383 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

170389 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170395 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170406 Public Employee & 

Pension/Retiree2 6/10/2021

Services and Agricultural Development Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170407 Public Employee 5/4/2021 Department of Agriculture Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170426 Public Employee & Pension/Retiree 6/10/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170429 Pension/Retiree1 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

170432 Public Employee 5/4/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

170435 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 392 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

170437 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

170438 Public Employee 5/4/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170466 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170486 Public Employee & Pension/Retiree 6/10/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170505 Public Employee & Pension/Retiree 6/10/2021 Department of Agriculture Y N/A Y Y N/A N N/A 170506 Public Employee & Pension/Retiree 6/10/2021 Department of Agriculture, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A Y Y N/A N N/A 

170508 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170513 Public Employee & Pension/Retiree 6/10/2021 Corps of Medical Emergencies Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

170535 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170543 Public Employee & Pension/Retiree 6/10/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

170550 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170572 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170585 Public Employee 7/2/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170598 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170604 Public Employee 3/30/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170607 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170614 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

170615 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170623 Public Employee & 

Pension/Retiree2 3/30/2021

Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 393 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

170624 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170632 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170633 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170641 Public Employee & Pension/Retiree 3/30/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170691 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170717 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170728 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170731 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170735 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170755 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170757 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170762 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170768 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170777 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170779 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170789 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170794 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170796 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170798 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 394 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

170799 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

170801 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170832 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Agriculture, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170839 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

170847 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170859 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170862 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170863 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170864 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170883 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170884 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170892 Public Employee 5/4/2021 Administration of Correction Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170898 Public Employee 3/30/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170900 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170907 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170908 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170924 Public Employee 3/30/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170927 Public Employee 5/4/2021 Department of Correction Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170940 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 395 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

170949 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170951 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170957 Public Employee & 

Pension/Retiree2 5/4/2021 Administration of Correction, Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

170962 Public Employee 5/4/2021 Administration of Correction, Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170978 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170981 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171002 Public Employee 3/30/2021 Administration of Correction, Department of Correction and Rehabilitiation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171011 Public Employee 5/4/2021 Administration of Correction, Department of Correction Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171019 Public Employee 5/4/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171020 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171021 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171022 Public Employee 7/2/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171025 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171026 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171047 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

171050 Pension/Retiree1 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

171065 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171069 Public Employee 12/20/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

171080 Public Employee & 

Pension/Retiree2 5/4/2021 Administration of Correction, Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 396 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

171082 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171100 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

171109 Public Employee & 

Pension/Retiree2 5/4/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171114 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171118 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171128 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171129 Public Employee 6/10/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171145 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171165 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171168 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171195 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171199 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171202 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171204 Public Employee 5/4/2021 Administration of Correction, Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171205 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171207 Public Employee 5/4/2021 Corps of Firefighters Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171218 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171224 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171228 Public Employee 5/4/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 397 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

171235 Public Employee 5/4/2021 Administration of Correction, Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171236 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171238 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171253 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171288 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171291 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

171292 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171300 Public Employee 5/4/2021 Administration of Correction, Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171307 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171315 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171337 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

171340 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171347 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171368 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171428 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

171444 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171527 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

171658 Public Employee 5/4/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171703 Pension/Retiree1 3/30/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 398 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

171726 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171733 Public Employee & Pension/Retiree 6/10/2021 Department of Sports and Recreation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

171741 Public Employee 5/4/2021 Department of Recreation and Sports Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171753 Public Employee 5/4/2021 Department of Recreation and Sports Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171773 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171779 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171789 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171810 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171826 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171828 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

171836 Public Employee 5/4/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171845 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171861 Public Employee & Pension/Retiree 6/10/2021 Corps of Firefighters Bureau, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171863 Public Employee & Pension/Retiree 7/13/2021 Corps of Firefighters Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

171891 Public Employee 7/13/2021 Department of Housing Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171908 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

171913 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171919 Public Employee3 6/10/2021 Department of Sports and Recreation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171922 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 399 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

171948 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

171952 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

171957 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

171963 Public Employee3 6/10/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171972 Public Employee & Pension/Retiree 7/13/2021 Corps of Firefighters Bureau, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 171976 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

171977 Public Employee3 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

172009 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172021 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

172034 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172039 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 172061 Public Employee 6/10/2021 Agency Not Provided Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172071 Public Employee 5/4/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172163 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 172171 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172184 Public Employee 5/4/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172187 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172193 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

172197 Public Employee 5/4/2021 Department of Recreation and Sports Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 400 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

172208 Public Employee3 6/10/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172226 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172232 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172272 Public Employee 5/4/2021 Department of Treasury (Negotiation of Collections) Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 172293 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172295 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

172309 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172315 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 172323 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172365 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172392 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172412 Public Employee & Pension/Retiree 3/30/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 172420 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 172438 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 172442 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172471 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172484 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

172504 Public Employee 5/4/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 172522 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 401 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

172524 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 172550 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172572 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 172585 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172590 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172593 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172594 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172595 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

172630 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172633 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172634 Public Employee & Pension/Retiree 6/10/2021 Administration of Correction Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

172642 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172644 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172653 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172744 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172801 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172825 Public Employee 5/4/2021 Administration of Correction Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172843 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

172846 Public Employee & 

Pension/Retiree2 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 402 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

172861 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172887 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 172899 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172906 Public Employee 3/30/2021 Administration of Correction, Department of Correction Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 172980 Public Employee 5/4/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172982 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173029 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173092 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173103 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173104 Public Employee3 3/30/2021

Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173108 Public Employee & Pension/Retiree 3/30/2021

Department of Family, Department of Social Services & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173135 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

173136 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

173139 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

173142 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

173143 Public Employee & Pension/Retiree 3/30/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

173157 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173165 Public Employee 3/30/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173177 Public Employee 3/30/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 403 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

173184 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

173185 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173193 Public Employee 3/30/2021 Department of Agriculture Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173197 Public Employee 3/30/2021 Department of Agriculture Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173208 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173211 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173227 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

173229 Public Employee & Pension/Retiree 3/30/2021 Public Service Commission & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173230 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173232 Public Employee 3/30/2021 Administration of Correction, Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

173239 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173240 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173241 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173244 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

173247 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173249 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173250 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173268 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173279 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 404 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

173282 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

173284 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

173295 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173297 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173327 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173352 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173474 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

173498 Public Employee 1/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173499 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173500 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173501 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173502 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173503 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173510 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173631 Public Employee 5/4/2021 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173632 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173718 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

173724 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

173731 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 405 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

173738 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173741 Public Employee 6/10/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173746 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173758 Pension/Retiree 1/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

173759 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173766 Public Employee 7/13/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173780 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173788 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173797 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 173801 Public Employee 7/13/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173841 Public Employee 7/13/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173885 Public Employee & Pension/Retiree 7/2/2021 Public Building Authority Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

173967 Public Employee & 

Pension/Retiree2 10/29/2021

Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174057 Public Employee & 

Pension/Retiree4 10/29/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174126 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 174131 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174139 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174160 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 174162 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 406 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

174164 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174170 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Justice Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174171 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174186 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174188 Public Employee & Pension/Retiree 6/10/2021 Department of Justice Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

174198 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 174200 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 174232 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 174239 Public Employee 5/4/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 174252 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174253 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

174254 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174260 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174276 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174277 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174278 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174279 Public Employee 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 174281 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174284 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 407 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

174290 Public Employee 4/21/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174296 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

174298 Public Employee & 

Pension/Retiree2 6/10/2021 Department of Family, Child Support Administration, Department of Finance Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

174299 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 174306 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174311 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 174313 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174318 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174333 Public Employee & 

Pension/Retiree2 5/4/2021 Administration of the Right to Work, Department of Labor Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

174336 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174348 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174351 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

174358 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174412 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174437 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

174441 Public Employee 5/4/2021 National Guard of Puerto Rico Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174451 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174462 Public Employee 5/4/2021 Administration of Correction, Department of Corrections and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 174465 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 408 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

174497 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

174502 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174508 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174509 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174511 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174515 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174521 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174522 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174524 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174525 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174526 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174527 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174528 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174529 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174530 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174558 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174560 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 174564 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

174565 Public Employee & Pension/Retiree 6/10/2021 Department of Justice Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 409 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

174572 Pension/Retiree 3/5/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

174582 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174601 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174602 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174603 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174604 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174605 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174606 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174607 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174608 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174619 Public Employee & 

Pension/Retiree2 6/10/2021

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174651 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174653 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174654 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174668 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174728 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174732 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174753 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174761 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 410 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

174766 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 174767 Public Employee 5/4/2021 Commonwealth of Puerto Rico Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174797 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174801 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174806 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174807 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 174823 Public Employee 5/4/2021 Department of Agriculture Y N/A Y Y N/A N N/A 174832 Union Grievance 8/25/2021 Public Building Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174840 Public Employee 5/4/2021 Admistration of Correction Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174849 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174868 Public Employee & Pension/Retiree 1/5/2022 Department of Social Services Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

174913 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 174918 Public Employee & Pension/Retiree 6/10/2021 Highway and Transportation Authority Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

174929 Public Employee3 6/10/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

174951 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 174962 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174979 Pension/Retiree6 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

175074 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175089 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 411 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

175092 Pension/Retiree6 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

175148 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

175158 Public Employee & Pension/Retiree 6/10/2021 Department of Family, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175164 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175175 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175199 Public Employee 5/4/2021 Department of Sports and Recreation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175205 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175237 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175239 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175241 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175245 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175246 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175273 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175274 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175291 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

175325 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175328 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175354 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

175356 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 412 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

175360 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175362 Public Employee 7/13/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175364 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175366 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

175380 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175382 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175383 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175385 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175388 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175390 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175395 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175396 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175446 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175465 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175491 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175493 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

175497 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175508 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175517 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 413 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

175519 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175545 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175575 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175581 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175586 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175587 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175590 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175594 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

175596 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175622 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175624 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175626 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175628 Public Employee 7/13/2021 Department of Public Safety Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175631 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175647 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175653 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175655 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175663 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

175766 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 414 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

175824 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175841 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175851 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175868 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175874 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175877 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175880 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175896 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175898 Tax Refund 7/13/2021 Department of Treasury Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 175899 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175902 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175911 Public Employee 6/10/2021 Department of Health, Administration of Health Facilities and Services Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

175920 Public Employee & Pension/Retiree 6/10/2021 General Services Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

175937 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175950 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

175957 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

175964 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175972 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175978 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 415 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

175985 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175986 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175987 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175997 Public Employee & Pension/Retiree 6/10/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 176066 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 176067 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 176068 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 176073 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176074 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 176075 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176087 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

176090 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

176095 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

176137 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176138 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176139 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176150 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176154 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176170 Public Employee 6/10/2021 Department of Sports and Recreation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 416 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

176175 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

176181 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 176185 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176190 Public Employee 5/4/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 176200 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

176206 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176212 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176262 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176263 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176265 Public Employee & Pension/Retiree 6/10/2021

Department of Correction and Rehabilitation & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176288 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176299 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

176302 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

176306 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 176318 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

176319 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176321 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176322 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176323 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 417 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

176324 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176327 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176330 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

176333 Public Employee & 

Pension/Retiree2 5/4/2021 Public Service Commission Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176351 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

176356 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176365 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176367 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 176372 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

176373 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176374 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 176398 Public Employee & Pension/Retiree 6/10/2021 General Services Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

176399 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176407 Public Employee 6/10/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176411 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176412 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 176414 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176417 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

176425 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 418 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

176439 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 176653 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176660 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 176678 Public Employee & Pension/Retiree 6/10/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 176681 Public Employee 5/4/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 176685 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176897 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177037 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177122 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177144 Public Employee 6/10/2021 La Furtaleza Governor's Office Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177166 Public Employee 6/10/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177170 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177176 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

177178 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

177179 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177180 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177227 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

177228 Public Employee 5/4/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177263 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 419 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

177265 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177283 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177414 Public Employee 5/4/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177443 Public Employee 5/4/2021 Department of Natural and Environmental resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177457 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177487 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

177511 Public Employee3 6/10/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177523 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177532 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177534 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177541 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177546 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177547 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177551 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177553 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177554 Public Employee 5/4/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177556 Public Employee 7/13/2021 Department of Health, Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177557 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

177563 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 420 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

177575 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177582 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177585 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177588 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177594 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

177595 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177596 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177599 Public Employee 7/2/2021 Department of Housing Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177602 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177603 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177615 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177624 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177627 Public Employee 5/4/2021 Highway and Transportation Authority Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177631 Public Employee & 

Pension/Retiree2 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177634 Public Employee & 

Pension/Retiree2 7/2/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177639 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177641 Public Employee & Pension/Retiree 6/10/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

177643 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

177646 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 421 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

177651 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177657 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177659 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

177669 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177680 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177682 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

177683 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177684 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177685 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177687 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177690 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177716 Pension/Retiree 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

177718 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177722 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177730 Public Employee, Pension/Retiree & Union Grievance 10/29/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

177740 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177745 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177774 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177780 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 422 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

177792 Public Employee & Union Grievance 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

177796 Public Employee3 6/10/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

177797 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177807 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177811 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177812 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177824 Public Employee3 6/10/2021 Department of Sports and Recreation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177830 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177835 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177877 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

177888 Public Employee 5/4/2021 Urban Housing Renovation Corporation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177915 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177923 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177925 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177941 Public Employee 5/4/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177950 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177954 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177975 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Recreation and Sports Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177996 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 423 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

178014 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178029 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178063 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178091 Public Employee 5/4/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178141 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178184 Public Employee 5/4/2021 Office of the Commissioner of Insurance Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178203 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178205 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178211 Public Employee & Pension/Retiree 6/10/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178216 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178308 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178339 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178355 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178378 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178400 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178402 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178414 Public Employee3 6/10/2021 Department of Natural and Environmental resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178421 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178433 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 424 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

178437 Public Employee & Pension/Retiree 6/10/2021

Department of Natural and Environmental Resources & Employees Retirement System of the Government of the Commonwealth of Puerto Rico 

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178463 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178465 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178470 Public Employee 5/4/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178471 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178484 Public Employee 10/29/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178511 Public Employee & 

Pension/Retiree2 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178537 Public Employee & Pension/Retiree 6/10/2021 Department of Sports and Recreation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178567 Public Employee & Pension/Retiree 6/10/2021 Department of Sports and Recreation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178586 Public Employee & Pension/Retiree 6/10/2021 Mental Health Services and Addiction Control Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178597 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178598 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178621 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178650 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178658 Public Employee 7/13/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178659 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178667 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178689 Public Employee3 6/10/2021 Department of Sports and Recreation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178704 Public Employee & Pension/Retiree 6/10/2021 Department of Health Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 425 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

178711 Public Employee3 6/10/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178722 Public Employee & Pension/Retiree 6/10/2021 La Furtaleza Governor's Office Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178729 Public Employee & Pension/Retiree 6/10/2021 Department of Sports and Recreation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178730 Public Employee & 

Pension/Retiree2 5/4/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178736 Public Employee 5/4/2021 Department of Recreation and Sports Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178740 Public Employee & Pension/Retiree 6/10/2021 National Parks of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178744 Public Employee3 6/10/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178745 Public Employee 7/13/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178747 Public Employee & Pension/Retiree 6/10/2021

Department of Natural and Environmental Resources, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178752 Public Employee3 6/10/2021 Department of Sports and Recreation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178755 Public Employee3 6/10/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178759 Public Employee3 6/10/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178762 Public Employee & Pension/Retiree 6/10/2021 Department of Sports and Recreation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178763 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178764 Public Employee & Pension/Retiree 6/10/2021 Department of Sports and Recreation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178769 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

178775 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178779 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178783 Public Employee 5/4/2021 Department of Sports and Recreation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 426 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

178792 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178798 Public Employee 6/10/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178801 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178806 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178810 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178815 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178822 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178848 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178849 Public Employee & Pension/Retiree 6/10/2021

Department of Natural and Environmental Resources & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178851 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178852 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178856 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178859 Public Employee & Pension/Retiree 7/13/2021 Department of Sports and Recreation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178860 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178861 Public Employee3 6/10/2021 Department of Treasury (Negotiation of Collections) Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178863 Public Employee 5/4/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178864 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178872 Public Employee 5/4/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178873 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 427 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

178883 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178897 Public Employee 5/4/2021 Department of Justice Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178899 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178907 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178908 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178909 Public Employee 7/2/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178910 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178916 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178922 Public Employee & 

Pension/Retiree2 5/4/2021 Public Service Commission Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178923 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178936 Public Employee3 6/10/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178939 Public Employee & 

Pension/Retiree2 5/4/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178941 Public Employee & Pension/Retiree 6/10/2021

Department of Sports and Recreation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178950 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178951 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178953 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178954 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178955 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178956 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 428 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

178957 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178958 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178959 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178960 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178962 Tax Refund 4/21/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178965 Public Employee 5/4/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178968 Pension/Retiree1 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

178977 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178982 Public Employee & Pension/Retiree 6/10/2021 Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178984 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178985 Public Employee 5/4/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178987 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178988 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 178989 Public Employee & Pension/Retiree 7/13/2021 Department of Education Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

178990 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178995 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

179009 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

179012 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179017 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 429 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

179021 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

179032 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179034 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179036 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179043 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179044 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179045 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179046 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179047 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179048 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179049 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179052 Public Employee 5/4/2021 Department of Sports and Recreation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179068 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179069 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179072 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179079 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Sports and Recreation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179084 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179085 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179094 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 430 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

179097 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179099 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179100 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179101 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179102 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179103 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179104 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179110 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179112 Public Employee 7/13/2021 Administration of Youth Institutions, Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179116 Public Employee3 6/10/2021 Department of Sports and Recreation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179117 Public Employee 5/4/2021 Department of Natural and Environmental Resources Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179120 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179129 Public Employee & 

Pension/Retiree2 5/4/2021 Department of Sports and Recreation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179130 Public Employee 5/4/2021 National Parks of Puerto Rico, Recreational Development Comp Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179138 Public Employee 5/4/2021 Department of Sports and Recreation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179147 Public Employee 5/4/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179153 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A N N/A 

179156 Pension/Retiree 7/2/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review7 

179167 Pension/Retiree 5/4/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 431 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

179176 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

179187 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

179200 Pension/Retiree 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

179201 Pension/Retiree1 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

179246 Public Employee & Pension/Retiree 7/13/2021 Planning Board Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

179281 Public Employee 7/2/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179297 Public Employee & Pension/Retiree 7/2/2021 Department of Health & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179298 Public Employee 8/25/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179331 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179339 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179341 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179386 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179399 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179409 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179410 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 179421 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179435 Public Employee & 

Pension/Retiree2 8/25/2021 Department of Health Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179436 Public Employee 8/25/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179491 Public Employee & 

Pension/Retiree2 8/25/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 432 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

179501 Tax Refund 8/25/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179528 Public Employee 8/25/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179565 Public Employee & 

Pension/Retiree2 10/29/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179676 Union Grievance 6/24/2022 Multiple Agencies Y N/A N N

Debtors advisors currently

working with Commonwealth 

government to gather information 

and complete agency review of 

claim

N N/A 

179701 Public Employee 12/28/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179702 Public Employee 12/28/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

179703 Public Employee 12/28/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

180099 Tax Refund 12/20/2022 Department of Treasury Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 180104 Tax Refund 12/20/2022 Department of Treasury Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 180150 Tax Refund 12/20/2022 Department of Treasury Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 180154 Tax Refund 12/20/2022 Department of Treasury Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 180157 Tax Refund 12/20/2022 Department of Treasury Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 180178 Tax Refund 12/20/2022 Department of Treasury Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 180179 Tax Refund 12/20/2022 Department of Treasury Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 180247 Tax Refund 12/20/2022 Department of Treasury Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 180488 Pension/Retiree 12/20/2022

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A N N/A 

10039-1 Tax Refund 2/24/2022 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

10225-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

102255-1 Union Grievance 7/13/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 433 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

106529-1 Public Employee & Pension/Retiree 7/13/2021 Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 107640-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

108234-1 Public Employee 12/20/2022 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

110250-1 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

11177-1 Union Grievance 7/13/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

11379-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

113880-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

11399-1 Union Grievance 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

114301-1 Public Employee 7/13/2021 Office of Court Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

114326-1 Public Employee & Pension/Retiree 7/13/2021 House of Representatives Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

11495-1 Tax Refund 2/24/2022 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

11703-1 Pension/Retiree 6/10/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

117101-1 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Treasury, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

117438-1 Public Employee 7/13/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

118303-1 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

12083-1 Union Grievance 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

121769-1 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

12201-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

122217-1 Public Employee 7/13/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 434 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

122236-1 Public Employee 12/20/2022 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

12495-1 Public Employee 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

125652-1 Public Employee & Pension/Retiree 7/13/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

12613-1 Public Employee 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

128370-1 Public Employee 12/20/2022 Department of Family Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

130238-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

130470-1 Public Employee 12/20/2022 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

13226-1 Public Employee & Union Grievance 7/13/2021 Vocational Rehabilitation Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

132771-1 Public Employee 12/20/2022 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

133080-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133338-1 Public Employee 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 133474-1 Public Employee & 

Pension/Retiree2 7/13/2021

Family and Children Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

133504-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

13521-1 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

136447-1 Public Employee 12/20/2022

 Department of Family, Vocational Rehabilitational Administration, Administration of Youth Institutions, Department of Corrections and Rehabilitation

Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

13651-1 Public Employee 7/13/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

13693-1 Public Employee3 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

13716-1 Union Grievance 7/13/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

138137-1 Public Employee 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 435 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

138317-1 Public Employee 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 138393-1 Public Employee & Pension/Retiree 7/13/2021 Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

13974-1 Public Employee 7/13/2021 Child Support Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

139810-1 Public Employee & 

Pension/Retiree2 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

139815-1 Public Employee 7/29/2022 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

140156-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

141526-1 Public Employee 7/13/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

14186-1 Union Grievance 7/13/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

14197-1 Public Employee3 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

142584-1 Public Employee 7/13/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

14267-1 Public Employee3 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

143153-1 Pension/Retiree6 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

144186-1 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

144930-1 Public Employee 7/13/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145026-1 Public Employee 7/13/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

145850-1 Tax Refund 3/30/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

14664-1 Public Employee3 7/13/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

14676-1 Union Grievance 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

147046-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 436 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

149300-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

149442-1 Public Employee 7/13/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150441-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

150714-1 Public Employee 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 150984-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

154816-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155084-1 Public Employee 7/13/2021

Department of Education, Highway and Transportation Authority, Puerto Rico Electric Power Authority

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

155410-1 Public Employee & Pension/Retiree 7/13/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

1562-1 Pension/Retiree 12/20/2022

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A N N/A 

156607-1 Union Grievance 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

156907-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157252-1 Public Employee 7/13/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

157527-1 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 157973-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159679-1 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Agriculture & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 159926-1 Public Employee 7/13/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

159974-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

160733-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163071-1 Public Employee & Pension/Retiree 7/13/2021 Puerto Rico Police Bureau Y N/A N N 3rd and Final Information Request letter sent to claimant; awaiting 

response

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 437 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

163083-1 Public Employee 7/13/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163453-1 Public Employee 7/13/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163463-1 Public Employee 7/13/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

163788-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

163996-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164539-1 Public Employee 12/20/2022

 Department of Family, Vocational Rehabilitational Administration, Administration of Youth Institutions, Department of Corrections and Rehabilitation

Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

164917-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

164949-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

167242-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

167423-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

168533-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

168607-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

168678-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

168729-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

168791-1 Public Employee & 

Pension/Retiree4 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

168905-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

169001-1 Public Employee 7/13/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 169018-1 Public Employee 7/13/2021 Department of Agriculture Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

169325-1 Public Employee 7/13/2021 Department of Agriculture Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 438 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

169363-1 Public Employee 7/13/2021 Department of Agriculture Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

169437-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

169608-1 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

169902-1 Pension/Retiree 8/25/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

169909-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

170140-1 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170153-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

170183-1 Public Employee 7/13/2021 Department of Agriculture Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170217-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

170276-1 Public Employee 7/13/2021 Department of Agriculture Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170314-1 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170450-1 Public Employee 7/13/2021 Department of Agriculture Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170494-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

170621-1 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Agriculture & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170636-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

170725-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

170743-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

170906-1 Public Employee & Pension/Retiree 7/13/2021 Administration of Correction, Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 170909-1 Public Employee 7/13/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 439 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

170992-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171023-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171028-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171048-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

171192-1 Public Employee & 

Pension/Retiree2 7/13/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171197-1 Public Employee 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171203-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171216-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171232-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171318-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171364-1 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171528-1 Public Employee & 

Pension/Retiree2 7/13/2021

Family and Children Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171569-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171750-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

171796-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

171905-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

171927-1 Public Employee & 

Pension/Retiree2 7/13/2021

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172132-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172134-1 Public Employee & Pension/Retiree 7/13/2021 Department of Agriculture & Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 440 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

172195-1 Public Employee, Pension/Retiree & Union Grievance 7/13/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

172216-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172277-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172446-1 Public Employee & Pension/Retiree 7/13/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

172517-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172520-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172688-1 Public Employee & Pension/Retiree 7/13/2021 Administration of Correction Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

172714-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

172733-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

172854-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

172855-1 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173423-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

173489-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

174443-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

174443-2 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Health, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

174599-1 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175081-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

175142-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

175382-1 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 441 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

175400-1 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 175581-1 Public Employee & 

Pension/Retiree4 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

175586-1 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

175588-1 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175647-1 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175650-1 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175907-1 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175937-1 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

175986-1 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 176082-1 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176139-1 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

17619-1 Union Grievance 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176265-1 Tax Refund 6/10/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

176682-1 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

176742-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

176752-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

177504-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177674-1 Public Employee 7/13/2021 Administration of Correction, Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 177733-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 442 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

177741-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

177971-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

17815-1 Public Employee 7/13/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

178995-1 Tax Refund 5/4/2021 Department of Treasury Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

179032-1 Tax Refund 5/4/2021 Department of Treasury Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

179047-1 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

18113-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

18266-1 Pension/Retiree6 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

19257-1 Tax Refund 7/29/2022 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

19312-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

21147-1 Union Grievance 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

23346-1 Public Employee & Union Grievance 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 24607-1 Public Employee 12/20/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

26099-1 Pension/Retiree6 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

26103-1 Public Employee 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 26107-1 Public Employee 12/20/2022 Department of Family Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 26122-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

27779-1 Public Employee 7/13/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 28107-1 Union Grievance 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 443 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

28425-1 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

28432-1 Public Employee & 

Pension/Retiree2 7/13/2021

Puerto Rico Police Bureau & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

29302-1 Public Employee & Union Grievance 7/13/2021 Family and Children Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

29492-1 Public Employee 7/29/2022

Department of Health, Department of Family, Mental Health Services and Addiction Control Administration

Y N/A N N

3rd and Final Information Request 

letter sent to claimant; awaiting 

response

N N/A 

31974-1

Union Grievance & Pension/Retiree5 7/13/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

32117-1 Public Employee & Union Grievance 7/13/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

32641-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

33758-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

33789-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

35103-1 Public Employee 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

35399-1 Public Employee & Pension/Retiree 7/13/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

36476-1 Public Employee 7/13/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

37021-1 Public Employee 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 37025-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

38315-1 Public Employee 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

38383-1 Union Grievance 7/13/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

38482-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

38765-1 Pension/Retiree1 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A N N/A 

40886-1 Union Grievance 7/13/2021 Socioeconomic Development of the Family Administration Y N/A Y Y N/A N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 444 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

41133-1 Union Grievance 7/13/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 44035-1 Union Grievance 7/13/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

45051-1 Public Employee & Union Grievance 7/13/2021 Department of Family Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

46270-1 Pension/Retiree 1/5/2022

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

47370-1 Public Employee 12/20/2022 Administration of Correction Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

4827-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

48377-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

48677-1 Pension/Retiree1 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

49206-1 Public Employee 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49646-1 Union Grievance 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

49847-1 Public Employee 7/13/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50108-1 Public Employee3 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50202-1 Public Employee 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50531-1 Union Grievance 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50897-1 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

50972-1 Public Employee 7/13/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

51417-1 Union Grievance 7/13/2021 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

51423-1 Public Employee 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 51452-1 Union Grievance 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 445 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

51909-1 Tax Refund 5/4/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

54146-1 Public Employee 7/13/2021 Family and Children Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

5537-1 Public Employee 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

57348-1 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

57421-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

57704-1 Public Employee 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 58953-1 Public Employee & 

Pension/Retiree2 7/13/2021

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

59034-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

59992-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

60868-1 Union Grievance 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 61017-1 Public Employee 7/13/2021 Childcare and Childhood Integral Development Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 61354-1 Public Employee 7/13/2021 Child Support Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

63113-1 Public Employee3 7/13/2021 Department of Education Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

63198-1 Pension/Retiree 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

63255-1 Union Grievance 7/13/2021 Socioeconomic Development of the Family Administration Y N/A Y Y N/A N N/A 65702-1 Union Grievance 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

65979-1 Public Employee & Pension/Retiree2 7/13/2021

Vocational Rehabilitation Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70726-1 Public Employee & Pension/Retiree 7/13/2021

Department of Correction and Rehabilitation, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

70744-1 Public Employee 12/20/2022

Department of Transportation and Public Works, Department of Education

Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 446 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

71643-1 Public Employee 12/20/2022 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

71688-1 Union Grievance 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

71873-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

7255-1 Public Employee 7/13/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

7264-1 Public Employee & 

Pension/Retiree2 7/13/2021 Puerto Rico Police Bureau Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

73013-1 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

7442-1 Union Grievance 12/20/2022 Department of Transportation and Public Works Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

75640-1 Public Employee 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 76519-1 Public Employee 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 78248-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

7924-1 Public Employee 7/13/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

79269-1 Public Employee 7/13/2021 Department of Family Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

79920-1 Public Employee & 

Pension/Retiree2 7/13/2021

Department of Family & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

81438-1 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 82133-1 Tax Refund 7/13/2021 Department of Treasury Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

82806-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

84867-1 Public Employee 12/20/2022 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 84983-1 Pension/Retiree1 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A N N/A 

85326-1 Public Employee & Pension/Retiree2 7/13/2021

Family and Children Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 447 of 450
Fifteenth Administrative Claims Resolution Status Notice

Claim 

Number

Type of Claim 

(Pension/Retiree, Tax Refund, 

Public Employee, Grievance)

Date 

Transferred into 

ACR

Responsible Agency

Claim Review 

Started? 

(Y/N)

Explanation for Delay in 

Review (Over 60 Days)

Complete 

Administrative 

File? (Y/N)

Initial 

Determination 

Complete? 

(Y/N)

Explanation for Initial 

Determination Extension 

(Beyond 90 Days)

Claimant Appeal 

from Initial 

Determination? 

(Y/N)

Status of Appeal

85610-1 Union Grievance 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 86282-1 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 88105-1 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Labor and Human Resources Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

88628-1 Pension/Retiree6 7/13/2021

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A Y In Process/Under Review 

89443-1 Public Employee 7/13/2021 Socioeconomic Development of the Family Administration Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 90282-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

9143-1 Public Employee & Union Grievance 7/13/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

94793-1 Public Employee & Pension/Retiree 7/13/2021 Department of Education, Employees Retirement System of the Government of the Commonwealth of Puerto Rico Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

9744-1 Public Employee & Pension/Retiree2 7/13/2021

Vocational Rehabilitation Administration, Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

9746-1 Public Employee 7/13/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

9749-1 Public Employee 7/13/2021 Vocational Rehabilitation Administration Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

97853-1 Public Employee & Pension/Retiree 7/13/2021 Department of Correction and Rehabilitation Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

98649-1 Public Employee & Union Grievance 7/13/2021 Puerto Rico Police Bureau Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

98826-1 Public Employee & 

Pension/Retiree2 7/13/2021 Department of Education, Teachers Retirement System Y N/A N N Information Request letter sent to claimant; response received and being reviewed. N N/A 

99284-1 Public Employee & 

Pension/Retiree2 7/13/2021

Socioeconomic Development of the Family Administration & Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99524-1 Public Employee 7/13/2021 Department of Correction and Rehabilitation Y N/A N N

Information Request letter sent to 

claimant; response received and 

being reviewed.

N N/A 

99585-1 Public Employee 12/20/2022

Department of Family, Vocational Rehabilitational Administration, Administration of Youth Institutions, Department of Corrections and Rehabilitation

Y N/A N N Information Request letter sent to claimant; awaiting response N N/A 

9987-1 Pension/Retiree 12/20/2022

Employees Retirement System of the Government of the Commonwealth of Puerto Rico

Y N/A Y Y N/A N N/A 

See Appendix A for footnotes 

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 D

Exhibit A Page 448 of 450
Appendix A

1 Claim was initially categorized as Public Employee & Pension/Retiree.  Upon further review, it

was determined that no Public Employee assertion was made, therefore the claim has been

recategorized as a Pension/Retiree Claim.

2 Claim was initially categorized as Public Employee.  Upon further review, it was determined

that in addition to the Public Employee assertion there is also a Pension assertion and therefore

will be re‐categorized as a Public Employee & Pension/Retiree Claim.

3 Claim was initially categorized as Public Employee & Pension/Retiree.  Upon further review, it

was determined that no Pension assertion was made, therefore the claim has been

recategorized as a Public Employee Claim.

4 Claim was initially categorized as Pension/Retiree Claim.  Upon further review, it was

determined that in addition to the Pension assertion there is also a Public Employee assertion

and therefore will be re‐categorized as a Public/Employee & Pension/Retiree Claim.

5 Claim was initially categorized as Union Grievance Claim.  Upon further review, it was

determined that in addition to the Union Grievance assertion there is also a Pension assertion

and therefore will be re‐categorized as a Union Grievance & Pension/Retiree Claim.

6 Claim was initially categorized as Public Employee.  Upon further review, it was determined

that no Public Employee assertion was made, therefore the claim has been recategorized as a

Pension/Retiree Claim.

7 This claim was previously marked resolved when claimant did not submit an appeal to their

Initial Determination within the allotted time. However, claimant had substantive duplicate

claims in ACR and response was received to claim put on objection. Accordingly, the Debtors

have reactivated the claim to allow for the response received.

8 This claim was previously marked resolved when claimant did not submit an appeal to their

Initial Determination within the allotted time. However, The Employees Retirement System of

the Government of the Commonwealth of Puerto Rico has accepted the claimants appeal and

the claim is currently under review.

9 This claim was previously marked resolved when claimant did not submit an appeal to their

Initial Determination within the allotted time. However, the Initial Determination was newly

identified as undeliverable.  Accordingly, the Debtors have re‐mailed the Initial Determination

to the claimant.

10 Claim was removed from the ACR Process (ECF No. 23108) and placed on objection exhibit to

expunge.

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 Desc:

Exhibit A Page 449 of 450
11 This claim was previously removed from ACR and placed on an objection to expunge due to

lack of adequate response. However, the claimant's recent response to the objection provided

additional detail in order for the Commonwealth and/or ERS to evaluate the claim.  Accordingly,

the Debtors have reactivated the claim to allow for the response received.

12 Claimant did not provide an address for request letters to be sent. The Debtors attempted to

reach out to the creditors via publication in several media locations. Affidavit of publication can

be found at Docket No. 23022.

13 Claims identified as “Resolved” on the First ACR Status Notice (ECF No.14515), Second ACR

Status Notice (ECF No.15367), Third ACR Status Notice (ECF No.15812), Fourth ACR Status

Notice (ECF No. 16322), Fifth ACR Status Notice (ECF No. 16684), Sixth ACR Status Notice (ECF

No.17659), Seventh ACR Status Notice (ECF No.18363), Eighth ACR Status Notice (ECF No.

19381), Ninth ACR Status Notice (ECF No. 19945), Tenth ACR Status Notice (ECF No. 20461),

Eleventh ACR Status Notice (ECF No. 21048), Twelfth ACR Status Notice (ECF No. 21599),

Thirteenth ACR Status Notice (ECF No. 22367) and Fourteenth ACR Status Notice (ECF No.

22901) are not included in this Status Notice.

Case:17-03283-LTS Doc#:23300-1 Filed:01/20/23 Entered:01/20/23 16:07:52 Desc:

Exhibit A Page 450 of 450