You offered to settle (1) $ (2) (3) overpayment by paying us $ (4) . We are writing to tell you that we cannot accept your offer. This means that (5) to pay back the full amount of the overpayment.
The Reason For Our Decision
We looked at the following things before we decided if we could accept your offer.
We looked at how the overpayment happened.
We looked at (6) ability to pay us back.
We looked at how close your offer was to the full amount of the overpayment.
After we looked at these things, we decided that we cannot accept the $ (7) offer you made. However, we might accept an offer that is closer to the amount (8) us. If you want to make another offer, contact (9) .
How To Pay Us Back
If you do not want to make another compromise offer, there are two ways you can pay
back the full amount of (10) overpayment.
You can send us a check or money order for the full amount of the overpayment. Make
your check or money order out to the Social Security Administration. Be sure to put
(11) , (12) on it. Please use the enclosed envelope to mail your check or money order to us.
If you can not send us the full amount now, send as much as you can. Then contact
(13) . You can pay the rest of the money (14) by making monthly payments.
If you cannot pay us in full, please contact us by (15) . You will need to tell us how you plan to pay us back.
3100FC (Foreign Cases Only):
If We Do Not Hear From You (Domestic Cases Only)
If you do not pay us or get in touch with us about this overpayment by (16) , we will consider sending (17) case to the Department of Justice.
If we do this, the Department of Justice might take you to court to collect the overpayment.
If that happens and the court decides against you, you might have to pay both the
overpayment and court costs.
If You Have Any Questions
3901C - Domestic
3901D - Foreign