Beruflich Dokumente
Kultur Dokumente
SS Number
04-1862134-3
Date of Birth 01-31-1989
Member Name
Date of Coverage
Monthly Premiums
Yea
r
Jan
Feb
Mar
Apr
May
0.00
0.00
Jun
0.00
Jul
Aug Sep
Oct Nov
Dec
0.00
201
1,092.0 1,092.0
832.0 884.0 884.0 884.0 1,560.0
936.00 832.00 832.00 884.00
832.00
2
0
0
0
0
0
0
0
201
1,248.0 1,040.0
1,144.0 884.0 884.0 832.0 832.0
884.00 884.00
936.00 884.00
884.00
1
0
0
0
0
0
0
0
201
832.0 884.0 832.0 936.0
832.00 780.00 780.00 832.00 780.00 832.00 832.00
884.00
0
0
0
0
0
200
9
0.00
0.00
0.00
0.00
0.00
0.00 416.00
Summary
45
45
41,912.00
Printa
ble
Version
"Information shown in any Module of the SSS Inquiry System is subject to change
and may differ from the actual amount of benefit or privilege that is due and payable
to the member."