We are writing about your request that we waive the collection of your Social Security
overpayment. Based on the facts we have, we cannot waive the collection of your overpayment
of $ (1) .
The Reason For Our Decision
For us to waive the collection of your overpayment, two things have to be true.
It was not your fault that you got too much Social Security money.
Paying us back would mean you cannot pay your bills for food, clothing, housing, medical
care, or other necessary expenses, or it would be unfair for some other reason.
Based on the facts we have, you do not meet both of these rules. The following will
tell you why.
We apply three tests when we decide if you are at fault in causing an overpayment.
The first is whether you made an incorrect statement or a statement which you knew
or should have known was incorrect. The second is whether you failed to give us timely
information which you knew or should have known was important. The third is whether
you accepted payments which you either knew or could have been expected to know were
Therefore, based on the facts we have, we cannot waive the collection of this overpayment.
This means that you must pay this money back.
How To Pay Us Back
You should refund this overpayment within 30 days. You can send us a check or money
order for the full amount of your overpayment of $ (4) . Make your check or money order out to the Social Security Administration. Be sure
to put your claim number, (5) , on it. Please use the enclosed envelope to mail the check or money order to us.
If you cannot pay us the full amount now, send as much as you can. Then contact any
Social Security office. You can pay the rest of the money you owe by making monthly
If You Disagree With This Decision
If You Want Help With Your Appeal
If You Have Any Questions
If you have any questions, you should call, write or visit any Social Security office.
If you visit an office, please bring this letter. It will help us answer your questions.