We enclose form SSA-3105, “Important Information about Your Appeal, Waiver Rights,
and Repayment Options,” with all Title II initial overpayment notices. This form gives
overpaid individuals additional information regarding their reconsideration and waiver
rights. The individual can use this form to request a repayment option, an explanation
of the overpayment, waiver of recovery, or reconsideration of the overpayment determination
by checking the appropriate box and returning the form.
You can view a copy of the SSA-3105 at OS 15010.725 or via inForms at http://inform.ssahost.ba.ssa.gov/libraryFormDetails.cfm?recordID=SSA-3105.