Effective Dates: 04/01/2025 - Present Previous | Next

TN 108 (04-25)

GN 02607.832 Recovery of Incorrectly Paid Prisoner Incentive Payments

To recover an incorrectly paid incentive payment (IP), the field office (FO) or processing center (PC)/Office of Central Operations-Office of Disability Operations (OCO-ODO) technician sends the correctional institution (CI) or mental health institution (MHI) an SSA-L4020, Prisoner Incentive Payment Recoupment Notice. The SSA-L4020 is a fillable form notice that a technician completes to inform the CI or MHI of an incorrect IP and request its return.

For instructions on requesting return of an incorrectly paid IP from a CI or MHI using the SSA-L4020, see GN 02607.832B in this section.

A. Reasons we issue an incorrect incentive payment (IP)

The reasons we may incorrectly pay an IP to a CI or MHI include the following:

1. Wrongly suspended Title II benefits

When we wrongly suspended benefits, we:

  • •

    did not completely develop a Prisoner Update Processing System (PUPS) alert to learn if a court convicted a beneficiary of a crime, or a court legally committed a beneficiary to an MHI at public expense in connection with a verdict or decision that the beneficiary is:

    1. a. 

      guilty but insane in connection with their criminal offense, or

    2. b. 

      not guilty by reason of insanity for their criminal offense, or

    3. c. 

      incompetent to stand trial or has another mental condition and is not legally liable for their crime.

  • •

    discovered after suspending benefits that a court convicted a beneficiary of a crime, but sentenced a beneficiary to confinement at a CI for 30 continuous days or less, or a court did legally commit a beneficiary for 30 days or less to an MHI at public expense in connection with a verdict or decision that the beneficiary is:

    1. a. 

      guilty but insane in connection with their criminal offense, or

    2. b. 

      not guilty by reason of insanity for their criminal offense, or

    3. c. 

      incompetent to stand trial or has another mental condition and is not legally liable for their crime.

2. Wrongly stopped Title XVI payments

When we wrongly stopped title XVI payments, we:

  • •

    did not completely develop a recipient’s or eligible spouse’s incarceration in a public institution (e.g., CI, jail, detention center, etc.) throughout a full calendar month, or

  • •

    acted upon information about a recipient’s or eligible spouse’s incarceration, but the institution gave us incorrect information due to a miscommunication (e.g., incorrect identification issue, inmate made bail after providing the incarceration information).

3. Prisoner Update Processing Systems (PUPS) created a PUPS alert for an incorrect beneficiary or recipient

We suspended or stopped a beneficiary’s or recipient’s benefits or payments without resolving their questionable Enumeration Verification System (EVS) code (i.e., identity verification) on the PUPS alert. PUPS automatically paid an IP to the facility on an incorrect PUPS alert, after the suspension or non-payment action processed, and PUPS ran the IP payment sweep.

4. PUPS paid the IP to the wrong CI or MHI because of incorrect facility coding on the PUPS record

The facility identification code (FID) on the PUPS record does not belong to CI or MHI where the confined inmate resides.

5. Recovery of an incorrectly paid IP

To recover the incorrectly paid IP, send the CI or MHI a Prisoner Incentive Payment Recoupment form notice, SSA-L4020. The SSA-L4020 is a fillable form notice that a technician completes to inform the CI or MHI of an incorrect IP and request its return. For instructions on requesting return of an incorrectly paid IP from a CI or MHI using the SSA-L4020, see GN 02607.832B in this section.

B. The IP recoupment process

1. FO or PC/OCO-ODO actions for requesting return of an incorrectly paid IP

Steps

Actions

1

Review Prisoner Update Processing System (PUPS) records or alerts to identify incorrectly paid IPs. Some common situations to look for while processing your prisoner cases include:

  • •

    Beneficiary was in a CI or MHI for 30 days or less, or a recipient’s confinement in a public institution was for less than one full calendar month;

  • •

    Beneficiary is confined in a CI or MHI, but not convicted of a crime or legally committed by a court order, respectively;

  • •

    PUPS misidentification of an incarcerated inmate as our beneficiary or recipient, (i.e., questionable EVS code of 2, 3, 4, A, B, E and F on the PUPS record) were not verified before we accomplished the suspension or non-payment action. (For more information about a questionable EVS code verification, see GN 02607.510.);

  • •

    We paid the IP payment to an incorrect CI or MHI (i.e., a different institution reported the inmate or, not the institution recorded on the PUPS record).

For a detailed list of reasons why we incorrectly paid an IP to a CI or MHI, see GN 02607.832A.1. in this section.

Once you identified one of these reasons, review the PUPS T2 Prisoner Status Query (P2QY), or the T16 Prisoner Status Query (T6QY) screens to determine if PUPS paid an IP for the Title II or the Title XVI prisoner report.

If PUPS paid a Title II or Title XVI IP, proceed to step 2.

If PUPS did not pay an IP, STOP, you do not need to take further action.

2

After finishing your other actions on the beneficiary’s or recipient’s prisoner issue, (e.g., reinstatement of monthly benefits or payments; annotating the Prisoner Remarks (PMRK) screen with information regarding an incorrect identity issue) prepare an SSA-L4020 for the CI or MHI that received the incorrect IP.

3

After you complete the SSA-L4020, print a copy of the completed form.

Find the CI or MHI’s address on the PUPS QPID screen and mail the completed and printed SSA-L4020.

For information to obtain the address to complete the SSA-L4020 and its mailing envelope, see GN 02607.832C.2. For information on the QPID screen, see MS PRISON 002.014

Place the CI’s or MHI’s addressed envelope in your component’s OUTGOING mailbox for delivery.

4

Hit the “SUBMIT by EMAIL” button embedded on the bottom of the SSA-L4020. This action produces two email messages that transfer the completed form to other CO components.

One email message transmits a copy of the completed SSA-L4020 to the Administrative Debt Management Team (DMT), Office of Finance (OF). This email displays the completed SSA-L4020 information, notifies the DMT about the incorrect IP amount and identifies the institution who received the incorrect IP. DMT’s receipt of the completed SSA-L4020 starts their tracking and control operation for return of the incorrectly paid IP from that specific CI or MHI.

A second email message transfers another copy of the completed SSA-L4020 to the PUPS Systems Manager (i.e., Office of Income Security Programs, Office of Representative Payee and Due Process Policy). The PUPS Systems Manager adds their copy of the completed SSA-L4020 to the universally viewable SSA-L4020 IP Recoup Forms SharePoint site.

2. CI or MHI inquiries about the SSA-L4020

Use the SSA-L4020 IP Recoup Forms SharePoint site to review completed copies of a CI’s or MHI’s SSA-L4020 that we mailed when responding to inquiries. For additional information on using the SharePoint site to locate a completed SSA-L4020, see GN 02607.832B.2.a. in this section.

a. Locating a SSA-L4020 that we mailed to a CI or MHI

If you receive an inquiry from a CI’s or MHI’s completed SSA-L4020, access and review the SSA-L4020 on this SharePoint site to assist in responding to the inquiry at SSA-L4020 IP Recoup Forms SharePoint site.

To respond to a CI’s or MHI’s inquiry and to locate the completed SSA-L4020, use the chart:

Steps

Actions

1

Ask the CI or MHI inquirer for information located on the completed SSA-L4020 in their possession including:

  • •

    name of the CI or MHI (incentive payee name indicated on the first two lines of the address field of the SSA-L4020), and

  • •

    facility ID code on the SSA-L4020 form notice (the facility ID code is located underneath the date), and

  • •

    location of the CI or MHI (the name of the city and the state code abbreviation for the CI or MHI is on the last line of the address field on the SSA-L4020), and

  • •

    date on the completed and mailed SSA-L4020 form notice.

2

After you obtain the information from the inquirer, access the SSA-L4020 IP Recoup SharePoint site to locate the completed SSA-L4020.

 

NOTE: This SharePoint site is a “view-only” site. You can read or print the completed SSA-L4020 from this site. You cannot edit or revise the SSA-L4020 using the SSA-L4020 IP Recoup SharePoint site.

3

After accessing the SSA-L4020 IP Recoup SharePoint site, go to the tab labeled “State.” Select the appropriate State using the information from the completed SSA-L4020 provided by the inquirer.

 

Next, locate the completed SSA-L4020 by looking for the incentive payee’s name that you obtained from the inquirer. The incentive payee’s name is located on the first and second lines of the completed SSA-L4020.

 

Review the completed SSA-L4020 to locate the facility ID code. You will find the facility ID underneath the date on the completed SSA-L4020. Make sure the facility code matches the information provided by the inquirer.

 

Finally, to ensure you have the exact notice the inquirer is referencing, match the completed SSA-L4020’s date entry to the notice date information provided by the inquirer.

 

EXAMPLE: The location of the CI’s or MHI’s completed SSA-L4020 on the SharePoint site is:

  • •

    State Tab = Maryland (This tab is the name of the state belonging to the state abbreviation that is part of the FID code for the facility, e.g., MD0000 = Maryland)

  • •

    Incentive payee name = Department of Corrections and Hygiene for Maryland

  • •

    Facility ID = MD0000

  • •

    Date = January 02, 2016

4

Once you locate and review the CI’s or MHI’s mailed SSA-L4020 from the SSA-L4020 IP Recoup Forms SharePoint site, respond to the CI’s or MHI’s inquiry. For instructions on answering inquiries on completed SSA-L4020s, see GN 02607.832.B.2.b. in this section.

b. Answering the inquiry

  1. 1. 

    Answer the inquiry, using the information on the CI’s or MHI’s mailed SSA-L4020 that is in the SSA-L4020 IP Recoup SharePoint site, and the IP information contained on the CI’s or MHI’s incentive payment records.

  2. 2. 

    The IP payment records include:

    • •

      the CI’s or MHI’s original IP payment letter found in ORS, and

    • •

      information contained on the CI’s or MHI’s PUPS QIPD screen, and

    • •

      information contained on the PUPS QIPA screen.

  3. 3. 

    Send any other inquiries about the completed SSA-L4020 to OF’s Customer Service at (410) 966-0113, via email to OF Debt Management Team or the PUPS Systems Manager for a response. The SSA-L4020 directs the correctional or mental health institution to contact the OF Customer Service telephone number or OF Debt Management Team e-mail address for assistance in repaying the incorrectly paid IP.

  4. 4. 

    Any other inquiries from the identified correctional or mental health institution that deal with the cause of the incorrect IP (inquiries other than how to repay the IP), to the PUPS Systems Manager for response via email.

3. Processing Center (PC)/Office of Central Operations-Office of Disability Operations (OCO-ODO) identifies incorrectly paid IP

For Title II processing instructions for incorrectly paid IPs, see GN 02607.832B in this section.

C. SSA-L4020 requesting return of the incorrectly paid IP

The SSA-L4020 (Prisoner Incentive Payment (IP) Recoupment Notice) is a fillable form notice that you send to an incorrectly paid CI or MHI. The notice notifies the institution that they received an incorrect IP and that the CI or MHI needs to refund or return the IP.

1. SSA-L4020 Prisoner Incentive Payment Recoupment Notice

Use this form to request return of an incorrectly paid incentive payment from a CI or MHI.

  • •

    Obtain the SSA-L4020 Prisoner Incentive Payment Recoupment Form from the inForm system.

  • •

    Complete the fill-ins on the SSA-L4020 notice.

    For instructions on completing the SSA-L4020, see GN 02607.872C.2. in this section.

    Save a copy of the completed SSA-L4020 notice to mail to the incorrectly paid CI or MHI.

  • •

    the “Submit by email” button at the bottom of the page to email the form to the two designated Central Office components. For information on the “Submit by email” button use, see GN 02607.832.B.1., step 4 in this section.

For information on mailing the completed SSA-L4020, see GN 02607.832.B.1. step 3, in this section.

2. Complete the SSA-L4020

The chart provides directions to complete the SSA-L4020 that you send to CI or MHI that received the incorrect IP.

Field on the SSA-L4020 Form

Fill-in(s) for the SSA-L4020 Field

Field Entries for the Top Right Portion of the SSA-L4020 Form

Field Office Address or PC/OCO-ODO (Street Address, City State and Zip Code)

Add your FO or PC/OCO-ODO address under the Social Security Administration line on the right-hand side of the form above the Facility ID No.

Facility ID No.

Add the six-position FID code for the incorrectly paid IP facility. Obtain the FACILITY ID code from the T16 PRISONER STATUS QUERY (P6QY) screen or the T2 PRISONER STATUS QUERY screen.

Date

Add five calendar days to the current date to allow for mailing time (the date entry = current date plus 5 calendar days for mailing time)

Field Entries for the Top Left Portion of the SSA-L4020 Form

Name of Incorrectly Paid Incentive Payee from the IPID Screen

Go to the Incarceration Report and Controls Systems (IRCS) Incentive Payment Identification Query (QPID) screen to add the CI’s or MHI’s mailing address to the SSA-L4020. Use the INCENTIVE PAYMENT DATA section of the QPID screen to obtain the Incentive Payee name and address to mail the SSA-L4020.

 

First and second lines of the address are the INCENTIVE PAYEE entry that is on the QPID screen. Add the Incentive Payee name to the SSA-L4020.

 

Use the QPID’s INCENTIVE PAYMENT DATA payee and address information to mail the SSA-L4020 because the CI or MHI provided the information contained in this section for an IP. This section also provides identification and contact information on the staff who have knowledge of the banking information for payment and receipt of a CI’s or MHI’s IPs.

Street Address

City, State, Zip Code from the IPID screen

Third address line begins with the address data under the INCENTIVE PAYEE field. Add in the entire address including street number, street, city, state abbreviation, and zip code.

Body of SSA-L4020 Notice

Paragraph 2

Description of the fill-ins

F1-1

MM/DD/YY (date printed on the correctional institution’s incentive payment (IP) notice that contains the incorrect IP we must recoup). NOTE: We place a copy of each correctional institution’s IP notice on the Online Retrieval System (ORS) when we pay an institution an IP. The IP notice provides the institution with information on the total IP deposit and it includes detailed information about each IP included in the deposit.

F2-1

$xxxx.00 (Dollar amount) (Total dollar amount of entire deposit made to the CI’s or MHI’s bank account for the month/year that we paid the incorrect IP.)

F3-1

$xxxx.00 (Dollar amount) (Amount of the incorrect IP)

F4 (1-5) Select one choice and add as the fill-in for this field

1--your institution confined our beneficiary for 30 continuous days or less

2--your public institution confined our recipient for less than one full calendar month

3--the prisoner in your institution was not our beneficiary

4--the prisoner in your institution was not our recipient

5--the incentive payment belongs to another correctional institution

F5 (1-4) Select one choice

1--our beneficiary’s early release from your institution

2--our recipient’s early release from your institution

3--the inmate’s actual identity

4--the other correctional institution’s misrouted incentive payment

F6 (Incorrectly paid IP information)

We will extract information for F6 for the incorrectly paid IP from the correctional institution’s IP notice.

  

Social Security Number: SSN on which we paid the incorrectly paid IP

Include only the last four digits of the SSN: XXX-XX-9999

  

Inmate ID: XXXXXXXXXX 10 numeric digits) If the inmate ID is less than 10 digits, add only the inmate ID information posted to the beneficiary’s or recipient’s PUPS record, or the inmate ID that is shown on the CI’s or MHI’s original incentive payment letter that is posted to ORS.

  

Payment: $XXX.XX (either $400.00 or $200.00)

  

Report Date: MM/DD/YY (e.g., 09/01/14)

  

Receipt Date: MM/DD/YY (e.g., 09/30/14)

  

Date Confined: MM/DD/YY (e.g., 08/02/14)

  

NOTE: Due to personally identifiable information (PII) requirements, only include the last four digits of the beneficiary’s or recipient’s SSN on the SSA-L4020 for the Inmate ID data entry.

Paragraph 4, bullet #2

Description of the fill-in

F7 Employer Identification Number (EIN)

XX-XXXXXXX (9 numeric digits) EIN for facility/reporter (We obtain this information from IRCS on the Incentive Payment Identification Query (QPID) Screen.)

3. Undeliverable mail SSA-L4020

We may receive returned SSA-L4020 forms that the United States Postal Service (USPS) could not deliver to the address shown on the envelope. The USPS will return an undeliverable SSA-L4020 notice to an FO or PC based upon the return address printed on the envelope. If an FO or PC receives a returned SSA-L4020 form, the FO or PC will re-mail the returned SSA-L4020. Follow instructions in the chart to re-mail the SSA-L4020 to the CI or MHI:

Steps

Actions

1

Check for a recent address change on the IRCS Incentive Payment Identification Query Screen (QPID), specifically on the INCENTIVE PAYMENT DATA section. Review the screen and compare it against the contact information posted to the address on the SSA-L4020. If there was a recent change, follow the instructions in Step 6.

 

If the mailing address on the SSA-L4020 and the QPID screen Incentive Payee address are the same, follow the instructions in Step 3.

2

If the USPS returns the SSA-L4020 with a forwarding address label on the envelope, follow the instructions in Step 3.

3

If no new address is on the QPID screen or you receive a forwarding address from the USPS, contact the INCENTIVE PAYMENT DATA CI’s or MHI’s contact person listed on the QPID screen. Use the daytime phone number on the QPID screen below the CONTACT NAME. Properly identify the CI or MHI’s contact person from the facility’s QPID screen before asking for or verifying a current address to re-mail the SSA-L4020. If you obtain a current address, follow the instructions in Step 6.

 

If direct contact with the INCENTIVE PAYEE is not successful, and you cannot obtain a new address for the CI or MHI, go to Step 4.

4

If direct contact with the CI or MHI’s QPID’s contact is not successful, query the CI’s or MHI’s Internet website to find a better mailing address, or a telephone number to call and request a better mailing address.

 

Once you obtain a better mailing address for the SSA-L4020, re-mail the notice with the current date to the address provided by your CI or MHI contact and continue to follow the instructions in Step 6.

 

If the contact information on the QPID screen requires changes, email your RPC to update the PUPS IPID to include the facility’s most current IP address and contact information that you obtained.

 

Send a courtesy copy of your email message to the RPC to ^IP Refunds, and OF.Debt.Management.Team@ssa.gov to notify these components of the change in the CI or MHI’s SSA-L4020 mailing address.

 

If you cannot locate a new address for the CI or MHI using the Internet, follow the instructions in Step 5.

5

If querying the CI’s or MHI’s Internet website is unsuccessful, send an SSA-L2001 (Address Information Request) to the USPS servicing the address of record.

 

If the USPS provides you with a new mailing address for the CI or MHI, follow the instructions in Step 6.

 

If USPS cannot provide you a new mailing address, follow the instructions in Step 7.

6

Re-mail the notice with the current date plus five mailing days to the address provided by the QPID screen IP Contact.

 

Email your Regional Prisoner Coordinator (RPC) to update the PUPS Incentive Payment Identification Data screen (IPID) to include the most current IP address for the CI’s or MHI’s IP address and contact staff information, if required. For instructions on emailing your RPC for the contact information, see GN 02607.990.

 

Send a courtesy copy of your email message to the RPC to ^IP Refunds, and Management.Team@ssa.gov to notify these components of the mailing address change on the SSA-L4020. Add the SSA-L4020 re-mailed date to your email. This date change will inform the Debt Management Team to revise their date for follow-up recontact of the incorrectly paid CI or MHI because of the re-mailing of the SSA-L4020 to the CI’s or MHI’s new address.

7

If all alternatives for locating a current mailing for a CI or MHI fails after pursuing steps 1 through 5 in this chart, email your RPC, ^IP Refunds, and OF.Debt.Management.Team@ssa.gov to notify these components that you could not re-mail the SSA-L4020 to the CI or MHI. Explain what steps you took to locate a new mailing address for the CI or MHI and the outcome of your search for a better mailing address.

In your email message state, “Stop tracking the collection of the incorrectly paid IP until we can obtain a valid address for the CI or MHI (add the actual name of the incorrectly paid CI or MHI here).”

 

EXAMPLE:

“Stop tracking the collection of the incorrectly paid IP until we can obtain a valid address for ABC Jail.”

 

The Debt Management Team will stop pursuing recoupment of the incorrectly paid IP from the CI or MHI until we can locate a valid mailing address for the CI or MHI.

D. Debt Management Team’s (DMT) tracking and control operation

1. DMT processing of SSA-L4020 form

DMT will review the SSA-L4020 (Prisoner Incentive Payment Recoupment Notice) that the technician generated to them via email. The DMT will annotate the incorrectly paid correctional or mental health institution on their Debt Management (DM) system and add an indicator to start tracking the return of the incorrectly paid IP from the institution. Once DMT adds the incorrectly paid CI or MHI to the DM system, DMT will:

  • •

    update their records to show that the correctional institution returned the IP if the CI or MHI returns the IP. We will need this information for our calendar year reconciliation reporting, or

  • •

    send a follow-up letter to the CI or MHI based on the information annotated to the DM system if we do not receive the IP after 30 days from the date on the SSA-L4020 form notice, or

  • •

    make one more attempt after 60 days to request return of the IP and send a second follow-up letter to the correctional or mental health institution or,

  • •

    monitor the return of incorrectly paid IP based on their second follow-up notice. If DMT does not get a response to the third follow-up notice after 95 days, they will discontinue collection actions on the incorrectly paid IP from the correctional or mental health institution. The DMT will annotate their records for this correctional or mental health institution as an “unsuccessful recovery,” (The DMT will retain this information for management information reporting purposes at the end of the calendar year.) and

  • •

    email the PUPS Systems Manager and request them to provide an administrative waiver of the $200 or $400 incorrectly paid IP for the identified correctional or mental health institution.

2. Non-recovery of incorrectly paid IP

If DMT could not successfully recover the incorrectly paid IP from a CI or MHI, then:

  • •

    The PUPS Systems Manager will prepare the administrative waiver and email it to the DMT for processing.

  • •

    DMT will terminate collection efforts on the $200 or $400 debt and will not forward the account to the Department of Treasury for recovery.

E. Exhibit – SSA-L4020 Prisoner Incentive Payment Recoupment notice and a copy of a completed SSA-L4020

1. SSA-L4020 for completion

View a copy of the SSA-L4020 form on the inForm system by clicking on the form’s number here: SSA-L4020.

2. SSA-L4020 notice fill-ins:

*F1-1 MM/DD/YY (date printed on the correctional institution’s incentive payment (IP) notice which contains the incorrect IP we must recoup). NOTE: We place a copy of each correctional institution’s IP notice on the Online Retrieval System (ORS) when we pay an institution an IP. The IP notice provides the institution with information on the total IP deposit and it includes detailed information about each IP included in the deposit.

*F2-1 $xxxx.00 (Dollar amount) (total dollar amount of deposit on the correctional institution’s IP notice)

*F3-1 $xxxx.00 (Dollar amount) (amount of the incorrect IP)

*F4-1 your institution confined our beneficiary for 30 continuous days or less.

*F4-2 your public institution confined our recipient for less than one full calendar month.

*F4-3 the prisoner in your institution was not our beneficiary.

*F4-4 the prisoner in your institution was not our recipient.

*F4-5 the incentive payment belongs to another correctional institution.

*F5-1 our beneficiary’s early release from your institution

*F5-2 our recipient’s early release from your institution

*F5-3 the inmate’s actual identity

*F5-4 the other correctional institution’s misrouted incentive payment

*F6-1 The information for this incorrect incentive payment is:

  • •

    Social Security Number: XXX-XX-XXXX (last 4 digits of incorrectly paid SSN from correctional institution’s IP notice)

  • •

    Inmate ID: XXXXXXXXXX (10 numeric digits)

  • •

    Payment: $XXX.XX (either $400.00 or $200.00)

  • •

    Report Date: MM/DD/YY (e.g., 09/01/14)

  • •

    Receipt Date: MM/DD/YY (e.g., 09/30/14)

  • •

    Date Confined: MM/DD/YY (e.g., 08/02/14)

    (We will extract information for F6 for the incorrectly paid IP from the correctional institution’s IP notice.)

*F7- (XX-XXXXXXX) (9 numeric digits) EIN for facility/reporter (We obtain this information from the Incarceration Reporting Control System (IRCS) Incentive Payment Identification Query (QPID) Screen.

3. Example of a completed SSA-L4020 notice

Social Security Administration



P.O. Box 2000

Richmond, CA 94802-2000

Facility ID No: CA0001

                                                July 3, 2016

       

 

   

 

Southern California Correctional Fund

Southern Springs Correctional Center

P.O. Box 123456

Anywhere, CA 91111

      

    

We are writing to tell you about an incorrect Social Security incentive payment that your institution received, and how you can pay this money back.

       

How The Incorrect Payment Happened

    

About 10/04/15, we deposited to your institution’s bank account an incentive payment of $11,800. You are not due $400 of this money because your institution confined our beneficiary for 30 continuous days or less. We did not learn about our beneficiary’s early release from your institution in time to stop the incorrect payment from depositing into your bank account.

The information for this incorrect incentive payment is:

  • •

    Social Security Number: xxx-xx-0000

  • •

    Inmate ID: 0009999999

  • •

    Payment: $400.00

  • •

    Report Date: 11/01/15

  • •

    Receipt Date: 11/04/15

  • •

    Date Confined: 10/03/15

    

How To Pay Us Back

  • •

    Check or money order payable to the Social Security Administration. Be sure to add your Employer Identification Number of 95-1234567 on the check and mail to:

    Social Security Administration

    Office of Finance

    P.O. Box 17042

    Baltimore, MD 21235-0742

    Attn: Incentive Payment Program

      

If you would like to discuss the repayment methods we have mentioned above, or other ways to repay us, you may contact our CUSTOMER SERVICE at (410) 966-0113, or

OF.Debt.Management.Team@ssa.gov.

 

Thank you for your prompt attention to this matter. We appreciate your continued participation in our Incentive Payment Program.

      

 

    

Form SSA-L4020 (02-2025)

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0202607832
GN 02607.832 - Recovery of Incorrectly Paid Prisoner Incentive Payments - 04/01/2025
Batch run: 04/28/2025
Rev:04/01/2025