We are writing to tell you about a change in court order number (1) concerning (2) responsibility for child support, alimony, or court ordered victim restitution, and
how it affects Social Security payments.
What We Plan To Do
(3) has asked us to take a different amount of money out of the monthly payments. We
will now (4) the monthly payments beginning (5) because of this change in the order.
What We Will Take Out
We will take out $ (6) from each monthly payment to collect the amount owed. You will receive a check for
$ (7) each month beginning with the check you will receive around (8) .
If You Disagree With This Decision
If you disagree with the decision of (9) , you will need to contact them directly, or have a lawyer do this for you. They
can be contacted at this address:
If You Have Any Questions