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Middlesex Massachusetts online Form 8917: What You Should Know
Filed: 8/4/2013 File #: 14-1662 1. Who is the Member? 2. What was the Member's Service? 3. When was the Member's Service? 4. What Disability is the Member Under Full Disability? 5. The Reasoning for Disabling the Member? 6. Where is the Member's Disability? 7. What is the Member's Service Period? 8. What is the Disability Program's Funding Source? 9. What is the Disability Program's Cost and Expenditure Schedule? 10. What is the Disability Program's Annual Outlay? 11. What is the Disability Program's Annual Operating Expense? 12. What is the Disability Program's Outcome? 13. What is the Disability Program's Expenditure Schedule? 14. The Member's Disability Benefit Plan. 15. What is the Disability Program Plan? If you are an individual who is totally and permanently disabled, please provide information in the areas described in paragraph 4. Below is a letter you can send to the office you filled the Member's Application for Disability Retirement. Pursuant to Title 5 C § Section 4-2021 of title 5 of the United States Code, I, Policymaker, Dear Member, This letter is in connection with your application for the disability retirement benefit plan under the laws administered by Personnel Massachusetts, Inc. And Department of Labor and Training. Although I am not a qualified disability practitioner who is authorized to prescribe medication under the laws administered by Personnel, I read what you are being told. Please do not hesitate to telephone, or mail your application via U.S. mailing, Fax, or email your application to me through Mass.gov. Thank you for your time and interest. Sincerely, Certified Professional Mass.gov Office of Disability Administration Application for Disability Retirement Request a Refund of Your Retirement Contributions Mass.gov Office of Disability Administration Pursuant to Title 5 C § Section 4-2022 of title 5 of the United States Code, I, Policymaker, Dear Member, This letter is in connection with your request for a refund of your retirement contributions.
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