RFU001 REQUEST FOR REFUND - OVERPAID PERSON IN NONPAY STATUS NO CROSS PROGRAM ADJUSTMENT POSSIBLE (A19) (G13)

(Requested/Generated)

Caption: How To Pay Us Back

You should refund this overpayment of  (1)  within 30 days. Please see the "Payment Options" page for the ways to make a payment.

If  (2)  cannot refund the full  (3)  now, you may request to repay in monthly installments. Please contact us promptly at (4)  to discuss a repayment plan.

RFU002 OVERPAYMENT REQUESTED - FOREIGN ADDRESS

(Systems Generated)

Caption: How To Pay Us Back

If you are unable to make a payment using one of the methods on the “Payment Options” page, please call our International Number promptly at 1-855-522-6936 (7am - 5pm Eastern Time) if you are outside the United States or its territories. You may also contact your nearest Federal Benefits Unit (FBU). Visit  (1)  for a list of FBUs. If you are in Canada, visit  (2)  to find the office that services your area. They will help you make the refund.

RFU007 SSI OFFSET NOT APPLICABLE (A59)

(Requested)

Caption: Your Benefits

Our records show that  (1)  did not get SSI money for  (2)  . So we can refund all of the Social Security money we held.

RFU008 REFUND/RETURNED CHECK(S) USED TO REDUCE OVERPAYMENT (A34)

(Requested)

Caption: Your Benefits

We used the amount refunded to replace  (1)  the money we  (2)   (3)  .

RFU012 REQUEST FOR REFUND AND ADJUSTMENT PROPOSED OVERPAID PERSON IN CURRENT PAY OVERPAYMENT EXCEEDS MONTHLY PAYMENT (A24)

(Requested/Generated)

Caption: How To Pay Us Back

You should refund this overpayment of  (1)  within 30 days. Please see the “Payment Options" page for the ways to make a payment.

If we do not receive  (2)  refund within 30 days, we will withhold up to 50 percent of  (3)  total monthly benefit starting with the payment  (4)  will receive on or about  (5)  . If  (6)  would like us to recover the overpayment from cross program adjustment notify us promptly at the phone number located at the bottom of this letter. We will continue to withhold the overpayment from the monthly benefit until we recover the entire overpayment.

If  (7)  full amount within 30 days or cannot afford to have us withhold 50 percent,  (8)  may request that we withhold a smaller amount each month. Notify us promptly if you would like to adjust the withholding rate for the overpayment by contacting us at the phone number located at the bottom of this letter. We may ask you questions regarding  (9)  resources, monthly expenses, and monthly income.

RFU020 FOREIGN REFUND REQUEST NONPAY STATUS (F19)

Caption: How To Pay Us Back

(System Generated)

You should refund this overpayment within 30 days.

Please see the “Payment Options" page for the ways to make a payment. If you are unable to make a payment using one of the methods on the “Payment Options” page, please call our International Number promptly at 1-855-522-6936 (7am - 5pm Eastern Time) if you are outside the United States or its territories. You may also contact your nearest Federal Benefits Unit (FBU). Visit  (1)  for a list of FBUs. If you are in Canada, visit  (2)  to find the office that services your area. They will help you make the refund.

If you cannot refund the full amount, you may request to repay in monthly installments. Please contact us promptly at 1-855-522-6936 to discuss a repayment plan.

If you have questions about Medicare, please visit Medicare.gov for information.

RFU036 REQUEST FOR REFUND AND ADJUSTMENT PROPOSED OVERPAID PERSON IN CURRENT PAY OVERPAYMENT EXCEEDS MONTHLY PAYMENT (A24)

(Requested)

Caption: How To Pay Us Back

Please refund this overpayment of  (1)  within 30 days. Please see the “Payment Options" page for the ways to make a payment.

If we do not receive the refund within 30 days, we will recover the overpayment by withholding  (2)  full monthly benefit starting with the payment you will receive on or about  (3)  . We will continue withholding  (4)  monthly benefits until we fully recover the overpayment.