We are writing to tell you about a change in (1) benefit amount. Although (2) not receiving regular monthly benefits now, (3) will receive a reduced amount if (4) benefits start again. This is because (5) government pension has increased.
The Information We Have
When we matched computer records with the Office of Personnel Management, we learned
the following information about (6) pension:
Please read the enclosed fact sheet, “Government Pension Offset.” This fact sheet will give you more information about how (9) benefits may change.
What You Can Do
Please let us know right away if any of this information is wrong. We cannot use this
information to change Social Security benefits until we give you time to check it.
You will also need to give us any proof you have that shows that our information is
If We Do Not Hear From You
If we do not hear from you within 30 days from the date of this letter, we will assume
the facts in this letter are correct and use them to reduce (9) Social Security benefits.
We will send another letter at that time. It will explain the change in benefits,
the amount of any overpayment, and how to appeal our decision.
You will have 60 days to ask for an appeal.
The 60 days will start the day after you receive the next letter.
If You Have Any Questions
3901C - Domestic
3901D - Foreign
SSA Pub. No. 05-10007