Social Security Administration Forms

Each year in July, retirees collecting a Social Security benefit and a City of Springfield pension check are sent a form from Social Security asking them to fill out certain information in regards to their retirement income. Filling out this form can be done by the retiree and does not need to be brought to the Retirement Office. Although we are always happy to assist you with this form and will continue to do so, we thought it would be helpful to give you the information you need if you would like to complete this form on your own.
Below is a list of the questions and answers.

Question 1: Has your pension changed since the previous year?
Answer: If you received a Cost of Living Increase (COLA) in July of the current year you would answer yes to this question. If no Cost of Living Increase was granted, you would answer no.
A cost of living increase (if approved) is always included in your July pension check – under earnings –COLA.
You will receive a statement at the end of July from the Springfield Retirement Office in which your COLA amount will be broken out. (see example)

Earnings
Pen 500.00
Annu 185.00
COLA 32.50

Question 2: What is your gross pension amount?
Answer: This amount will be on the statement you receive at the end of July- under check totals –Total Pay– this is your gross monthly check -fill in the amount on your statement under Total Pay. (see example)

Check Totals
Total Pay 717.50

Question 3: Effective date of this amount.
Answer: If a Cost of Living (COLA) is received the date will always be July 1, of the current year.
If no COLA was granted the date would be July 1 of the last year you received a COLA increase.

Question 4: May we contact your employer?
Answer: Yes

You will need to provide the Retirement Systems address and phone number:

Springfield Retirement System
70 Tapley Street
Springfield, MA 01104.
Phone number (413) 787-6090.

Then you should sign and date the form and mail it to the Social Security Administration.