We are writing to tell you that we plan to reduce (1) past Social Security benefits (2) because (3) filed for benefits as the (4) of (5) . Here is what we were given as proof:
We plan to pay benefits to (7) . When we do this, we will reduce the benefits you received. 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 (8) days of the date of this letter if you disagree with the decision. You will also
need to give us any proof that (9) benefits should not be reduced.
If you let us know within (10) days that you disagree with the decision, we will not reduce (11) past benefits. We will 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 (12) days, we will reduce (13) past benefits. We will send you another letter at that time with more information
about our action.
If You Have Any Questions
3901C - Domestic
3901D - Foreign
*For foreign beneficiaries, use 30 days.