Our records show that you earned $ (1) in (2) . We assume that you worked in all months in (3) after you became entitled to Social Security benefits.
If you disagree with (4) and you can show (5) wrong, or if you did little or no work in (6) after you became entitled to Social Security benefits, please get in touch with any
Social Security office and we will correct our records.
Based on the information we have now, $ (7) should have been withheld from your benefits for (8) .
Based on this, you received $ (9) more in Social Security benefits that you were due.
How to Pay Us Back
If You Think You Should Not Have To Pay Us Back
If You Disagree with the Decision
If you Want Help With Your Appeal1
Information About Work and Earnings
If You Have Any Questions
1 If the person has an attorney, omit this paragraph.