TN 31 (02-97)

NL 00703.116 Followup Notice — Immediate Adjustment — Opportunity For Personal Conference Previously Given — Underpayment Withholding Involved

Document Identifier for Word Processor: E3116

A. Exhibit Letter

We previously notified you that you were overpaid. The amount we must recover is now
$ (1) . This takes into account the additional $ (2) due you for (3) .

 

3116ASince monthly benefits are now payable to you, we are recovering the overpayment by withholding your full benefit beginning with the payment you would normally receive about (1) . We will continue to withhold your benefit until the overpayment has been fully recovered.
or
3116B
Since monthly benefits are now payable to you, we are recovering the overpayment from the payment you would normally receive about
(1) . The reduced payment will be $ (2) and you will receive your regular monthly payment about (3) .
or
3116C
Since monthly benefits are now payable to you, we plan to recover the overpayment from the payment you would normally receive about
(1) . You will receive your monthly payment again about (2) .
3116DCall us at 1-800-772-1213 if the planned withholding of your payment will cause hardship or you prefer to refund the overpayment balance so that withholding of your payment is not necessary.
or
3116E
Please call, write or visit (1) if the planned withholding of your payment will cause hardship or you prefer to refund the overpayment balance so that withholding of your payment is not necessary. Please take this letter with you if you do visit an office.

 

If You Have Any Questions

3901C

B. Requesting Instructions

The person who decides the overpayment can be adjusted (generally the benefit authorizer) is responsible for requesting this notice and providing the appropriate fill-ins.

  • Use 3116A if the overpayment exceeds the monthly payment.

  • Use 3116C if the overpayment equals the monthly payment.

  • Use 3116B if the overpayment is less than the monthly payment.

  • Use 3116D and 3901C for domestic cases.

  • Use 3116E if the person lives outside the U.S.

     

Fill-ins:

  1. amount of overpayment

  2. amount of underpayment

  3. month(s)

     

3116A(1)month/day/year payment would have been received
3116B(1)month/day/year payment would have been received
 (2)amount of payment
 (3)month/day/year payment will be received
3116C(1)month/day/year payment would have been received
 (2)month/day/year payment will be received
3116E(1)Use a fill-in from 3901D in NL 00703.005E.

C. Typing Instructions

Because the fill-ins may vary according to the different situations, follow the requester's typing instructions carefully.