TN 9 (05-02)

Prepare an SSA 831/832/833-U3 the same as for ALJ/AC decisions without court involvement in title II cases with the following exceptions:

• Item 27 of the SSA-831-U3: Show the remark “see item 34.”

• Item 34 of the SSA-831-U3 and Item 24 of the SSA-833-U3 show the remark “Decision of the U.S. District Court for the district/state dated mm/dd/yyyy” or “Decision of the U.S.C.A. for the (Circuit number) dated (mm/dd/yyyy).” (See DI 42010.020A. for additional SSA-831-U3 preparation instructions. Refer to DI 42010.020G. for SSA-833-U3 preparation instructions and GN 03106.039 for Component Protest situations).