We wrote you  (1)  to let you know that we overpaid you $ (2)  in Social Security benefits and how this overpayment happened. We told you about
            your right to question our decision. We also told you what to do if you thought the
            overpayment was not you fault or if you could not afford to pay it back.
         
         You still owe us $  (3)  . Please read this letter carefully because it gives you important information about
            your rights. It also tells you how to pay back the money you owe.
         
          
         Your Right To Question Our Decision 
         When we wrote to you before, we said you had 60 days to ask us to review the overpayment
            decision. We call this a reconsideration. Even though the 60-day period is over, you
            can still ask for a reconsideration if you have a good reason for taking longer than
            60 days to do this.
         
          
         If You Think You Should Not Have to Pay Us Back 
         You can also ask us to waive, or excuse, collection of your overpayment. You will
            not have to pay us back if:
         
         
            - 
               
                  • 
                     It was not your fault that we paid you too much, AND 
 
 
- 
               
                  • 
                     One of the following is also true: —Paying the money back would mean you could not pay your bills for important things
                        like food, clothing, housing or medical care; OR
                      —It would be unfair if you had to pay the money back. 
 
 
If you ask us to waive your overpayment and we decide not to waive it, we will:
         
            - 
               
                  • 
                     Send you a letter to let you know our reasons, AND 
 
 
- 
               
                  • 
                     Give you a chance to meet with a Social Security representative to talk about our
                        decision. We call this a personal conference.
                        
 
 
How to Pay Us Back 
         
            
               
                  
                  
               
               
                  
                  
                     
                     | 3186A | To do this, you can write us a check or money order. Please make it out to the Social
                           Security Administration. Be sure to put your Social Security claim number, which is
                           shown above, on your check. Also, use the enclosed envelope to mail it to us.
                         If you can not pay back all of the money you owe us right away, you can: 
                           
                              
                                 • 
                                    give us some of the money, AND
                              
                                 • 
                                    tell us why you can not pay the full amount, AND
                              
                                 • 
                                    tell us how you plan to pay the rest. | 
                  
                     
                     | OR | 
                  
                     
                     | 3186B | Please send us a check or money order for United States dollars, or you can send a
                           check or money order in local currency equal to the United States dollars. When you
                           pay us in local currency, we use the exchange rates in effect at the time we get your
                           payment. If this causes a difference between the amount you pay us and the amount
                           you owe us, we will let you know. If you cannot mail your payment directly to us,
                           please go to the nearest U.S. Embassy or consulate. They will help you make the refund.
                         If you can not pay back all of the money you owe us right away, you can: 
                           
                              
                                 • 
                                    give us some of the money, AND
                              
                                 • 
                                    tell us why you can not pay the full amount, AND
                              
                                 • 
                                    tell us how you plan to pay the rest. | 
               
            
          
          
         If You Want Help With Your Appeal1 
         3100E
          
         If You Have Any Questions 
         3901C - Domestic
 3901D - Foreign
         
          
         Enclosure: 
         Refund Envelope
          
         1 If the beneficiary has an attorney or lives outside the U.S., omit this paragraph.