Your Social Security Statement Template (Page 2 of 4) in pdf

Your Estimated Benefits

*Retirement You have earned enough credits to qualify for benefits. At your current earnings rate, if you

stop working and start receiving benefits…

At age 62, your payment would be about ................................................................................................. $

975 a month

If you continue working until…

your full retirement age (67 years), your payment would be about ......................................................... $ 1,412 a month

age 70, your payment would be about ...................................................................................................... $ 1,761 a month

*Disability

You have earned enough credits to qualify for benefits. If you became disabled right now,

your payment would be about .................................................................................................................. $ 1,293 a month

*Family

If you get retirement or disability benefits, your spouse and children also may qualify for benefits.

*Survivors

You have earned enough credits for your family to receive survivors benefits. If you die this

year, certain members of your family may qualify for the following benefits:

Your child ................................................................................................................................................. $ 1,008 a month

Your spouse who is caring for your child ................................................................................................ $ 1,008 a month

Your spouse, if benefits start at full retirement age ................................................................................. $ 1,344 a month

Total family benefits cannot be more than ............................................................................................... $ 2,473 a month

Your spouse or minor child may be eligible for a special one-time death benefit of $255.

Medicare

You have enough credits to qualify for Medicare at age 65. Even if you do not retire at age 65, be sure

to contact Social Security three months before your 65th birthday to enroll in Medicare.

* Your estimated benefits are based on current law. Congress has made changes to the law in the

past and can do so at any time. The law governing benefit amounts may change because, by 2040,

the payroll taxes collected will be enough to pay only about 74 percent of scheduled benefits.

We based your benefit estimates on these facts:

Your date of birth ............................................................................................................................................April 5, 1966

Your estimated taxable earnings per year after 2006 .............................................................................................$38,626

Your Social Security number (only the last four digits are shown to help prevent identity theft) ............. XXX-XX-1234

How Your Benefits Are Estimated

To qualify for benefits, you earn “credits” through your

(3) Your benefit amount may be affected by military

work — up to four each year. This year, for example,

service, railroad employment or pensions earned

you earn one credit for each $1,000 of wages or self-

through work on which you did not pay Social

employment income. When you’ve earned $4,000,

Security tax. Following are two specific instances.

you’ve earned your four credits for the year. Most people

You can also visit

need 40 credits, earned over their working lifetime, to

to see whether your Social Security benefit amount

receive retirement benefits. For disability and survivors

will be affected.

benefits, young people need fewer credits to be eligible.

Windfall Elimination Provision (WEP) — In the future,

We checked your records to see whether you have earned

if you receive a pension from employment in which you do

enough credits to qualify for benefits. If you haven’t

not pay Social Security taxes, such as some federal, state

earned enough yet to qualify for any type of benefit, we

or local government work, some nonprofit organizations

can’t give you a benefit estimate now. If you continue to

or foreign employment, and you also qualify for your

work, we’ll give you an estimate when you do qualify.

own Social Security retirement or disability benefit,

What we assumed — If you have enough work

your Social Security benefit may be reduced, but not

credits, we estimated your benefit amounts using

eliminated, by WEP. The amount of the reduction, if any,

your average earnings over your working lifetime.

depends on your earnings and number of years in jobs in

For 2007 and later (up to retirement age), we assumed

which you paid Social Security taxes, and the year you

you’ll continue to work and make about the same as

are age 62 or become disabled. For more information,

you did in 2005 or 2006. We also included credits

please see Windfall Elimination Provision (Publication

we assumed you earned last year and this year.

No. 05-10045) at

Generally, estimates for older workers are more accurate

Government Pension Offset (GPO) — If you receive a

than those for younger workers because they’re based

pension based on federal, state or local government work

on a longer earnings history with fewer uncertainties

in which you did not pay Social Security taxes and you

such as earnings fluctuations and future law changes.

qualify, now or in the future, for Social Security benefits as a

These estimates are in today’s dollars. After you

current or former spouse, widow or widower, you are likely

start receiving benefits, they will be adjusted for cost-of-

to be affected by GPO. If GPO applies, your Social Security

living increases.

benefit will be reduced by an amount equal to two-thirds

We can’t provide your actual benefit amount until

of your government pension, and could be reduced to zero.

you apply for benefits. And that amount may differ

Even if your benefit is reduced to zero, you will be eligible

from the estimates stated above because:

for Medicare at age 65 on your spouse’s record. To learn

(1) Your earnings may increase or decrease in the future.

more, please see Government Pension Offset (Publication

(2) Your estimated benefits are based on current law.

No. 05-10007) at

The law governing benefit amounts may change.

(c)

Your Social Security Statement Template Page 2

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