Social Security Administration
         Billing Statement
         Important Information
          
         Susan A Patrick
         for Children
         1234 5th Avenue
         Huntington NY 10101
         (Bar Code goes here)
          
         STATEMENT DATE:        08/06/02
          
         ACCOUNT NUMBER:      12345678901
          
         AMOUNT DUE:                $00.00
          
         BALANCE FROM PREVIOUS STATEMENT                                $30.00
          
         PAYMENT RECEIVED - 07/12/02 - THANK YOU                         $30.00
          
         NEW BALANCE                                                                              $0.00
          
         This statement concerns an overpayment of Social Security benefits paid in error to
            SUSAN PATRICK, C1; JOE A PATRICK, C2; JOHN A PATRICK, C3; and FRED PATRICK, C4.
         
          
         This bill is paid in full. Thank You.
          
         If you have any questions, you may call us at 1-718-557-6600 TOLL FREE. The office
            hours are Monday through Friday, 7:15 A.M. through 6:00 P.M. EST. Please have this
            statement available when you call.
         
          
         If you call us using a TDD machine, please pause after you type a few words. This
            will give us time to transfer your call to the TDD line.