We are writing to tell you that we plan to reduce (1) Social Security benefits as a (2) . This is because we learned that (3) a government pension. Based on the information we have, we should have reduced (4) Social Security benefits starting (5) .
The Information We Have
When we matched our computer records with the Office of Personnel Management’s records.
We learned the following about (6) pension.
Monthly Payment(s) |
Effective Date(s) |
$ (7) |
(8) |
Please read the enclosed fact sheet, “Government Pension Offset.” This fact sheet will give you more information about how (9) benefits may change.
What You Can Do
Please let us know right away if any of this information is wrong. We cannot use this
information to figure Social Security benefits until we give you time to check it.
You will also need to give us any proof you have that shows that our information is
wrong.
If We Do Not Hear From You
If we do not hear from you within 30 days from the date of this letter, we will assume
the information in this letter is correct and use it to reduce (10) Social Security benefits.
We will send another letter at that time. It will explain the change in (11) benefits, the amount of any overpayment, and how to appeal our decision.
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You will have 60 days to ask for an appeal.
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The 60 days will start the day after you receive the next letter.
If You Have Any Questions
3901C - Domestic
3901D - Foreign
Enclosure:
SSA Pub. No. 05-10007