We are writing to tell you that we plan to stop your checks (1) as of (2) because we were told that (3) .
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 you have to show that what we were told is wrong.
If you let us know within 101 days that you disagree with the decision, we will not stop your checks. We will continue
to pay you while we review your 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 stop 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