Social Security Administration

Retirement, Survivors and. Disability Insurance Notice of Award

MiaAmerica Program Service Center

601 East Twelfth Street

Kansas City,Migour) 611062817

SBD Date: Fabri

SAMSHDDS8250-A

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axes murs SAS05 nous 729 PHY

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You are entitled to monthly retirement benefits beginning January 2024.

What We Will Pay And When

We example, paySocial Security benefits foragiven month in the next month, For Social Security benefits for March arepaidin April

©You will receive $3,170.70 around February 4,2024,

This is the money you are due for January 2024.

Your next payment of $2,996.00, which is for cna L, will be Teceived on or abe,the third Wednesday ofMar<

. Bet tltet vou will receive $2,996.00 on or about the third Wednesday of

©These selected, andPlease anyfuture lotut

payments knowiYou wilGhange gotothe financial intitation you

insend you letters directly.

your maltng sass osee zg

‘* Later in this letter, we will show you how we figured these amounts.

Others Who May Be Eligible For Benefits

Your child may now beeligible for benefits on your record. You named the following child when you applied for benefits

©CATHERINE PLATA

If you have not filed an application for benefits for the child, please contact

Enclosure(s):

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24MS862D35260-A

Page 2of 5

Information About Medicare

Your Medicare Part A (hospital

(medical insurance) insurance) starts July 2022 and Part B starts February

Xpu Whenwill

you

get

need

a Medicare

medical

card within 2 weeks. Youshould show this

care. To learn mor about Visit Medicare,Fo", I

jedicarecovers, 1-800-MEDICARE you have questions about yourMears coverage, call (1-800-633-4227),

RARORTANT.

higher premiums.

AMedicare ‘Thelawapplies lawrequires Yoprensiume sme higher incomepersons to pay fe Medicare Bar B(Medical Insurance), prescription drugcoverage’ndMedicere Immunosuppressive

higher

Dr average ally affects inaividuate with couples avi Incomeahi We will contact 000.

income. If we decide

the Internal Reven 0a ‘nforiation about sour

letter explaining ourdecision.

that you have

The

te‘par >Pay rermiums, wewill send a higher antte February

Internet or

2024.

cail

"For

us toll-free

moreinform: ration Please visit www.ssa.gov onmnthe at TON.FDISTae TS

Medicare Prescription Drug Plan Enrollment

Now

Prescription

that you are eligible for Medicare, you can enroll in aMedicare drug plan (Part D).

enrol,

‘0learn

visit

moreinoue the, Medicare oFall prescription drugplans and when youcan 1-900-MEDI Ret.

can

187-496-048).

help you

Medicare alsocan tell ou abot coea your area that choose your prescription drug roverage.

If

gxtza

you

help

have

that

limited

is available

income and resources, we encourage you to my for the

The extra help can pay

to assist with Medicareproacription rugcosts,

prescription the monthly premiums, annual deductibles co-payments. ‘To learn more or apply, please ceriaia

Other Social Security Benefits

Phils

future,

benefit if you

is

think

the only

you

benefit

might

you can receive from us at this time. In the

need to apply again

qualify for another benefit from us, you with

Your Responsibilities

changes,

Your benefits

it could

are based ontheinformation you gave us. If this information

‘you report changes

affect

to

asbenelite For this Fenson,it is taportenrat us right awe

paihave

Retirement

enclosed

Or Survivors

apamphlet,

Benstiies

"What

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Know When You <

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2AMS862D36250-A Page 3of 5

Your Benefits May Be Taxed

You spayhave to pay taxes on the benefits you get from us. Part of your Social Security benefite may betex

©©you

you

are

are

single and your total income is more $25,000 0 married and you and your spouse have total incomeof more than $32,000.

You can decide if you want to have federal taxes withheld from you benefits. If you want taxes withheld, you need to complete and return aForm

fhholding Requ Form WAV from the oucanlaa getthis form Ty mes.htm on our website. complete ineform,return it to your local Social Securityoffice by bal or mew

‘You can find

"What

jore information on paying taxes in the enclosed pamphlet, *dTo Know When You Get Retirement Or Survivors Benefits’,

Do You Disagree With The Decision?

XEyou do not agree with this decision, you havetherightae We wilt

facts you ‘sonwhodid not

5©You have 60days to sk for an appeal

The 60 daysstart the day after you thie letter. We aasume you received this letter 5 days after the date on it unless you show ‘wethet cid not iod. © receive it within the 5-day peri Youmust ‘good reason for waiting more than 60 days to ask for anappea

. ust askfor anappeal in writing.Please uour “Request for Reconsideration” formeBSNSOSPoumayg0to our website at "forms! to locate the form. "Youcanalsocontact usto Fequest the form, orifyouneedhelp filling out the fosey

IfYou Want Help With Your Appeal

You can have afriend, representative, or Someone else helpyou, There are fours that con help you find arepresentative oFgive youfree legal services you qualify. Thereare a20.representatives whadoaot chareeines fem your appeal. Your local Social Security ‘lten has ise ‘groups that tan help you with your a

If you get someone tohelp you, You should let us know. If you hire someon we must approveth ovshecan collect it: Andif you hive s Tepresentative of who is ‘hgh fyfor direct pay,we will withhold up to 25 percent any past due benefits topay toward the

than “|

iw Vakalsiy: wee: by call In pe Service byali

www.socialsecurity= smnerah x :

YouNe oy +

jew your caiéand look atany newf ave.“Aper make the first cision ul aseyour case. We will review thepartsorthe decision

decision

that

that

you

inay

think

or may

are wrong and correct any mistakes. We kea not befn your favor

Lk

receiv

st tb

, a

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24MS862D35260-A

Page 4of 5

Suspect Social Security Fraud?

686ov/r 501-3101) or call the Inspector General's Fraud Hotline

Fengvisit bit Heigs 1

If You Have Questions

Need more help?

2

L

rafor fast, simple, andnd secureonline service, 721213,weekdays ve,defor hard of hearing 7.00 pm. If you

this letter when

call TTYYannaor, ee mention 3 callyourlocal office at 1-888-717-1630,

RASOCIAL SECURITYCOLORADODO BLVD

How are we doing? Go to www.ssa.gov/feedback to tell us.

Social Security Administration

I

,

Hit Pango

at 1.800.260.0077 erry”

~ bo e

Visit www.ssa, Calhayethan .

a

You may also

1you eat, ~

veutUN TX 76205,

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24MS862D35260.4

PAYMENT SUMMARY

Your Regular Monthly Payment

Here is how we figured yo

regular monthly paymenteffective February 2024:

You are entitled to amonthly benefit of ....

Amounts we subtracted because of:

©premiums for medical insurance

This equals .

awhole dolla

©rounding (we must round down to

This equals the amount of

your regular monthly payment

Your Payment Of $3,170.70

Here is howwe figured your

first paymen

Benefits due for January 2024 ..

Additional smount we subtracted for medicalinsurance premi

due one monthin advance...

This equals theamount of

your first payme

Page 5of 5

+-$ 3,171.40

174.70

2,996.70

2-8 3,345.40

174.70

-9 3,170.70

-70

+-$ 2,996.00

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J&M Civil Construction Services, LLC

Profit and Loss

January 1 - March 22, 2024

Cash Basis Friday, March 22, 2024 07:03 PM GMT-05:00 1/1

TOTAL

Income

Total Income

GROSS PROFIT $0.00

Expenses

Overhead Expenses

Computer Software 94.86

Total Overhead Expenses 94.86

Total Expenses $94.86

NET OPERATING INCOME $ -94.86

NET INCOME $ -94.86

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