Reporting Changes and Requesting Other Post-Entitlement Actions

How to report a change in status to the Social Security Administration

Change of Address

If you have moved from the U.S. to Poland please complete the form SSA-21 and send it to us.

If you changed your address within Poland please contact us and provide the following information:

• Your name
• Your Social Security Number or your Claim Number if you receive family benefits
• Your new address and telephone number.

Death of a Beneficiary

Please contact us as soon as possible and provide:

• The deceased beneficiary’s name and Social Security or Claim Number
• Date of death
• Place of death
• If you chose to notify us by mail please also include your name, relationship to the deceased person and your contact information.

Please also provide the death certificate, if available.

It is important to notify us of the beneficiary’s death immediately to avoid possible overpayments. Please keep in mind that the last payment due the deceased beneficiary is for the month preceding the month of death. Please do not cash any paper checks after the beneficiary’s death and, if the payments were made to the bank account directly, please make sure the bank is informed of the account holder’s death.

Direct Deposit of Social Security Benefits

Residents of Poland can have benefits paid by one of the following methods:

• Paper check mailed to your address
• Direct deposit to the U.S. bank account; to sign up for domestic direct deposit please fill out the SF-1199A form and send it to us
• Direct deposit to the account in the Pekao SA bank in Poland. If you wish to receive your benefits to your dollar account in Pekao SA please send us the completed SF-1199-CDD form. Please consult us if you receive benefits on behalf of your minor child. The cost of a single money transfer is $3.00 and PLN10.00.
• Direct deposit to a dollar account in PKO BP, BGŻ, BPH and Citibank. If you wish to sign up for direct deposit to one of the above banks please complete form SF-1199–PO and send it to us. Important: due to involvement of U.S. banks we are unable to provide the total cost of a money transfer. It depends on the fee charged by the U.S. bank.

Medicare Part B Termination

If you wish to terminate your Medicare Part B coverage, please send us completed form CMS-1763. Please remember that your coverage will continue throughout the month following the month in which you file your termination request.

Delayed Payment or a Missing Check

If you have not received an expected payment and did not receive an explanation of delay or suspension from SSA please report it to us after the 20^th of the month in which you expected the payment to come. The message should include the following information:

• Your name
• Your Social Security Number or your Claim Number if you receive family benefits
• The month in which you expected the payment to come (for example if you want to report non-receipt of the check for July 2011 which should have been delivered to you in August 2011, please report non-receipt on the check due in August 2011).

Request a U.S. Tax Statement for Polish Authorities

If you are neither a U.S. citizen nor a Lawfully Admitted Permanent Resident and a U.S. income tax is withheld from your benefits (for more information on Alien Taxation please go here) you can request a tax statement in Polish, which will be accepted by the Polish fiscal authorities and banks. Please write to us and provide the following information:

• Your name
• Your Social Security Number or your Claim Number if you receive family benefits
• Request to issue a tax statement in Polish.

Report Award of a Polish Pension to Social Security Administration

Your foreign pension can affect the amount of your U.S. benefits. You are therefore obliged to report such pension to the Social Security Administration. It is important to report it as soon as possible to avoid potential overpayment of SSA benefits. If you were awarded foreign pension after you filed your claim for the U.S. benefits please notify us immediately by completing the form SSA-308 and sending it to us along with your Polish pension award notice.

If you want to read more on how your foreign pension or pension for work not covered by SSA can affect your U.S. benefits please go here.