We are writing to tell you that we plan to reduce (1) Social Security benefits (2) to $ (3) as of (4) because (5) filed for benefits as the (6) of (7) . Here is what we were given as proof:
We plan to pay benefits to (9) . When we do this, we will reduce the benefits you receive. This is because we have
a limit on how much we can pay on each person's Social Security record.
If You Disagree With The Decision
Please tell us within 101 days of the date of this letter if you disagree with the decision. You will also
need to give us any proof that your benefits should not be reduced.
If you let us know within 101 days that you disagree with the decision, we will not reduce your checks. We will
continue to pay you while we review the case to see if you are right. However, if
you are wrong we will ask you to pay back any money you received that was not due.
If we do not hear from you within 101 days, we will reduce your checks. We will send you another letter at that time with
more information about our action.
If You Have Any Questions
3901C - Domestic
3901D - Foreign