TN 25 (10-16)

NL 00730.130 O Paragraphs and Captions

A. O Paragraphs and Captions

ONS003 – EXPLANATION TO THE DISABLED ADULT CHILD WHEN HE OR SHE BECAME ENTITLED TO DISABILITY BENEFITS

We found that (1) became disabled under our rules on (2).

Fill-in values:

 

Fill-in (1)

 

Choice 1

you

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Date of entitlement

OPTC01 – CAPTION

Overpayment Information

OPT029 – NEW OVERPAYMENT – OVERPAYMENT NOT DUE TO TERMINATION

We paid (1) (2) for (3). Since we should have paid (4) (5) for (6), we paid (7) (8) more than (9) (10) due.

Fill-in values:

 

Fill-in (1)

 

Fill-in (1)

 

Choice 1

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Choice 2

you

Fill-in (2)

Sum of the Monthly Benefit Credited (MBCs) on the pre-MBR starting with the internal Business Start Date and ending with Current Operating Month (COM) minus 1 month in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

Internal Business Start Date in format Month CCYY

Choice 2

Internal Business Start Date plus “and” plus Current Operating Month (COM) minus 1 month in the format Month CCYY

Choice 3

Internal Business Start Date plus “through” plus Current Operating Month (COM) minus 1 month in the format Month CCYY

Fill-in (4)

 

Choice 1

him

Choice 2

her

Choice 3

you

Fill-in (5)

Sum of the Monthly Benefit Credited (MBCs) on the pre-MBR starting with the internal Business Start Date and ending with Current Operating Month (COM) minus 1 month in the format $$$$$.¢¢

Fill-in (6)

 

Choice 1

Internal Business Start Date in format Month CCYY

Choice 2

Internal Business Start Date plus “and” plus Current Operating Month (COM) minus 1 month in the format Month CCYY

Choice 3

Internal Business Start Date plus “through” plus Current Operating Month (COM) minus 1 month in the format Month CCYY

Fill-in (7)

 

Choice 1

him

Choice 2

her

Choice 3

you

Fill-in (8)

Difference between Trigger Record New Overpayment Amount (TR-NEW-OPA-AMOUNT) and total Trigger Record Other Beneficiary Overpayment Amount (TR-OTH-BENE-OPA) in the format $$$$$.¢¢

Fill-in (9)

 

Choice 1

he

Choice 2

she

Choice 3

you

Fill-in (10)

 

Choice 1

was

Choice 2

were

OPT064 – EXPLAINS TO A WORKING BENEFICIARY THERE IS AN OVERPAYMENT ON HIS OR HER RECORD FOR ONE YEAR BECAUSE THE EARNINGS THEY REPORTED IS DIFFERENT FROM WHAT SSA RECORDS SHOW

We recently found that the earnings (1) for (2) and the earnings information we have do not match. (3) told us (4) earned (5) in (6) but our records show that (7) earned (8). If our records are correct, we paid (9) (10) too much.

Fill-in values

 

Fill-in (1)

 

Choice 1

”reported for” plus Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Choice 2

“reported for you”

Fill-in (2)

Year in the format CCYY

Fill-in (3)

 

Choice 1

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Choice 2

You

Fill-in (4)

 

Choice 1

he

Choice 2

she

Choice 3

you

Fill-in (5)

Amount of reported earnings (AORE)

Fill-in (6)

Year of Earnings Report (YOER) in the format CCYY

Fill-in (7)

 

Choice 1

he

Choice 2

she

Choice 3

you

Fill-in (8)

Amount of reported earnings (AORE)

Fill-in (9)

 

Choice 1

him

Choice 2

her

Choice 3

you

Fill-in (10)

Overpayment amount

OPT065 – EXPLAINS TO A WORKING BENEFICIARY THAT BECAUSE THE EARNINGS PREVIOUSLY POSTED FOR MULTIPLE YEARS ARE LESS THAN THE EARNINGS ON THE MASTER EARNINGS RECORD, THERE ARE OVERPAYMENTS FOR MULTIPLE YEARS

We recently found that the earnings reported for (1) for the years shown below and the earnings on our records do not match. If our records are correct, we paid (2) (3) too much.

Fill-in values:

 

Fill-in (1)

 

Choice 1

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Choice 2

you

Fill-in (2)

 

Choice 1

you

Choice 2

him

Choice 3

her

Fill-in (3)

Overpayment amount in the format $$$$$.¢¢

OPT084 – EXPLAINS TO A WORKING BENEFICIARY THAT BECAUSE THE EARNINGS PREVIOUSLY POSTED FOR A SINGLE YEAR ARE LESS THAN THE EARNINGS ON THE MASTER EARNINGS RECORD AND NO BENEFITS WERE WITHHELD FOR THIS YEAR, THERE IS AN OVERPAYMENT FOR JUST ONE YEAR

Our records show that (1) had earnings in (2) of (3) that we did not consider when we paid (4). If our records are correct, we paid (5) (6) too much.

Fill-in values:

 

Fill-in (1)

 

Choice 1

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Choice 2

you

Fill-in (2)

Year of Earnings Report (YOER) in the format CCYY

Fill-in (3)

Amount of reported earnings (AORE)

Fill-in (4)

 

Choice 1

him

Choice 2

her

Choice 3

you

Fill-in (5)

 

Choice 1

him

Choice 2

her

Choice 3

you

Fill-in (6)

Overpayment amount

OPT085 – TELLS THE BENEFICIARY THE OVERPAYMENT AMOUNT

(1), (2) us (3).

Fill-in values:

 

Fill-in (1)

 

Choice 1

After all the changes (use when earnings caused more than 1 adjustment)

Choice 2

As a result (use when earnings caused a single adjustment)

Fill-in (2)

 

Choice 1

you owe

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) plus “owes”

Fill-in (3)

Total overpayment amount

OPT086 – EARNINGS PREVIOUSLY POSTED FOR MULTIPLE YEARS ARE LESS THAN THE EARNINGS ON THE MASTER RECORD AND NO BENEFITS WERE WITHHELD, THEREFORE, THERE ARE OVERPAYMENTS FOR EACH YEAR

Our records show that (1) had earnings for the years shown below that we did not consider when we paid (2). If our records are correct, we paid (3) (4) too much.

Fill-in values:

 

Fill-in (1)

 

Choice 1

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Choice 2

you

Fill-in (2)

 

Choice 1

him

Choice 2

her

Choice 3

you

Fill-in (3)

 

Choice 1

him

Choice 2

her

Choice 3

you

Fill-in (4)

Total overpayment amount

OPT087 – CHART HEADING UTI THAT PROVIDES THE WORKING BENEFICIARY THE EARNINGS POSTED WITH NO BENEFITS PREVIOUSLY WITHHELD FOR THAT YEAR EARNINGS

Earnings On

Year Our Records

OPT088 – EXPLAINS TO A WORKING BENEFICIARY IN A CHART THE EARNINGS POSTED WHEN NO BENEFITS WERE PREVIOUSLY WITHHELD FOR THESE EARNINGS

(1) (2)

Fill-in values:

 

Fill-in (1)

Year of Earnings Report (YOER) in format CCYY

Fill-in (2)

Amount of reported earnings (AORE)

OPT096 – PRIOR OVERPAYMENT WITH A PROTEST AND PROTEST DECISION STILL PENDING

We already told you that we paid (1) (2) too much for a past period. We will send you another letter to let you know what we will do about the recovery of that money.

Fill-in values

 

Fill-in (1)

 

Choice 1

you

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

 

Choice 1

Due process overpayment amount in the format $$$$$.¢¢

Choice 2

Null

OPT097 – RECOVERY OF AN INCORRECT PAYMENT

Once we get back the money (1) not due for this year, we will start to withhold (2) benefits to get back the other money (3).

Fill-in values

 

Fill-in (1)

 

Choice 1

you were

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) plus “was”

Fill-in (2)

 

Choice 1

your

Choice 2

his

Choice 3

her

Fill-in (3)

 

Choice 1

you owe

Choice 2

he owes

Choice 3

she owes

OPT107 – FULL OR PARTIAL WITHHOLDING FOR ONE MONTH

We will withhold (1) (2) (3) (4) payment to recover the money we (5) (6). This is the payment you would normally receive about (7).

Fill-in values:

 

Fill-in (1)

 

Choice 1

Overpayment amount

Choice 2

Null

Fill-in (2)

 

Choice 1

from

Choice 2

Null

Fill-in (3)

 

Choice 1

your

Choice 4

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)

Fill-in (4)

Recovery of the overpayment date in the format Month CCYY

Fill-in (5)

 

Choice 1

overpaid

Choice 2

incorrectly paid

Fill-in (6)

 

Choice 1

you

Choice 2

him

Choice 3

her

Fill-in (7)

Date the overpayment will be deducted in the format Month DD, CCYY

OPT122 – NEW OVERPAYMENT DUE TO RETROACTIVE TERMINATION

Since we did not stop (1) payments until (2), (3) paid (4) too much in benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)

Choice 2

your

Fill-in (2)

Current Operating Month (COM) in format Month CCYY

Fill-in (3)

 

Choice 1

he was

Choice 2

she was

Choice 3

you were

Fill-in (4)

New overpayment amount in $$$$$.¢¢

OPT123 – TOTAL OVERPAYMENT INCLUDES PRIOR OVERPAYMENT

(1) total overpayment of (2) includes (3) prior overpayment.

Fill-in values:

 

Fill-in (1)

 

Choice 1

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)

Choice 2

Your

Fill-in (2)

Due Process Overpayment (DPO) on the post-MBR in format $$$$$.¢¢

Fill-in (3)

 

Choice 1

his

Choice 2

her

Choice 3

your

OPT125 – BENEFICIARY'S OVERPAYMENT BEING RECOVERED FROM ANOTHER AUXILIARY

We paid other person(s) on this record (1) more in benefits than we should have. Under Social Security law, you are responsible for this overpayment.

Fill-in values:

 

Fill-in (1)

Other beneficiary's overpayment amount in format $$$$$.¢¢

OPT127 – ADVISES OF OVERPAYMENT RECOVERY AMOUNT (OPRA) ON POST-MBR

We used (1) of (2) benefits to recover (3) of an overpayment on this record.

Fill-in values:

 

Fill-in (1)

Overpayment Recovery Amount (OPRA) on post-MBR in format $$$$$$.¢¢

Fill-in (2)

 

Choice 1

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)

Choice 2

your

Fill-in (3)

 

Choice 1

all

Choice 2

part

OPT128 – BENEFICIARY’S NEW OVERPAYMENT, BENEFICIARY’S PRIOR OVERPAYMENT AND ANOTHER BENEFICIARY’S OVERPAYMENT

(1) total overpayment of (2) includes (3) prior overpayment and another beneficiary's overpayment that (4) (5) liable for under Social Security law.

Fill-in values:

 

Fill-in (1)

 

Choice 1

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)

Fill-in (2)

Due Process Overpayment (DPO) amount on the post-MBR in format $$$$$.¢¢

Fill-in (3)

 

Choice 1

his

Choice 2

her

Choice 3

your

Fill-in (4)

 

Choice 1

he

Choice 2

she

Choice 3

you

Fill-in (5)

 

Choice 1

is

Choice 2

are

OPT131 – REMAINING BALANCE ON PRIOR OVERPAYMENT

(1) (2) an outstanding balance remaining on a prior overpayment. That remaining balance is (3).

Fill-in (3)

Remaining overpayment amount or the old overpayment amount in format $$$$$.¢¢

OPT132 – PIC A (H) DIES OR PIC B DIES AND HAVE JOINT BANK DATA ON MBR AND THERE IS AN OVERPAYMENT

We paid (1) more in benefits than we should have. We deposited (2) benefits for (3) into a bank account which (4) also owned. We can't pay benefits for the month of death, (5), or later. Because (6) a joint owner of the bank account, (7) overpaid (8).

Fill-in values:

 

Fill-in (1)

 

Choice 1

New overpayment amount

Fill-in (2)

 

Choice 1

NH-FULL name (possessive) when PIC A died and PIC B is responsible for the overpayment

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive) when PIC B died and PIC A is responsible for the overpayment

Fill-in (3)

 

Choice 1

Beneficiary's date of death when Beneficiary Date of Death (BDOD) = Current Operating Month (COM) minus 1 month

Choice 2

Beneficiary's date of death plus “and” plus the Current Operating Month (COM) minus 1 month when the Beneficiary Date of Death (BDOD) = Current Operating Month (COM) minus 2 months

Choice 3

Beneficiary's date of death plus “through” plus Current Operating Month (COM) minus 1 month when the Beneficiary Date of Death (BDOD) > Current Operating Month (COM) minus 2 months

Fill-in (4)

 

Choice 1

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Choice 2

you

Fill-in (5)

 

Choice 1

Beneficiary Date of Death (BDOD) for PIC A in the format Month CCYY

Choice 2

Beneficiary Date of Death (BDOD) for PIC B in the format Month CCYY

Fill-in (6)

 

Choice 1

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) plus “is”

Choice 2

you are

Fill-in (7)

 

Choice 1

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) plus “is”

Choice 2

you are

Fill-in (8)

 

Choice 1

Trigger Record New Overpayment Amount (WS-TR-NEW-OPA) in the format $$$$$.¢¢

Choice 2

Trigger Record Other Beneficiary Overpayment Amount (WS-TR-OTH-BENE-OPA) for WS-TR-OTH-OPA-BIC = A or WS-TR-OTH-BENE-OPA-BIC = B in the format $$$$$.¢¢

OPT133 – BENEFICIARY(S) DIE AND OVERPAYMENT RECOVERED FROM ANOTHER ENTITLED BENEFICIARY

We paid you (1) more in benefits than we should have. The overpayment occurred because we did not stop (2) benefits for (3). We can't pay benefits for the month of death, (4), or later.

Fill-in values:

 

Fill-in (1)

 

Choice 1

New overpayment amount

Choice 2

If more than one dead beneficiary is overpaid and overpayments are being recovered from another entitled beneficiary, then show the total amount of all overpaid beneficiaries

Fill-in (2)

 

Choice 1

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive) for one overpaid beneficiary

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive) plus “and” for two overpaid beneficiaries followed by the Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive) for the second overpaid beneficiary

Choice 3

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive) followed by a comma followed by Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive) for the second overpaid beneficiary plus “and” followed by Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive) for the third overpaid beneficiary

NOTE: If more than three dead beneficiaries with the same BDOD and overpaid, then an Incomplete notice will be generate (see Incomplete Notices under the Completion Code section for the CODE and more information)

Fill-in (3)

 

Choice 1

Beneficiary's date of death when Beneficiary Date of Death (BDOD) = Current Operating Month (COM) minus 1 month

Choice 2

Beneficiary's date of death plus “and” plus the Current Operating Month (COM) minus 1 month when the BDOD = COM minus 2 months

Choice 3

Beneficiary's date of death plus “through” plus COM minus 1 month when the Beneficiary Date of Death (BDOD) > Current Operating Month (COM) minus 2 months

Fill-in (4)

Beneficiary Date of Death (BDOD)

OPT147 – DUE PROCESS TITLE II OVERPAYMENT RECOVERY LESS THAN FULL MONTHLY BENEFIT AMOUNT

We plan to recover this overpayment (1) the payment (2) would normally receive about (3).

Fill-in values:

 

Fill-in (1)

 

Choice 1

from

Choice 2

by withholding

Fill-in (2)

 

Choice 1

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Choice 2

you

Fill-in (3)

Use the Due Process Recovery Date (DPRD) plus 1 month to determine the month and year; then using the Payment Cycle Indicator (PCI) on the post-MBR call the PCI utility to get the correct day that corresponds to the determined month and year and show this date as the Fill-in value in the format Month DD, CCYY

OPT148 – TITLE XVI (SSI) UNDERPAYMENT USED TO REDUCE OR RECOVERY A TITLE II OVERPAYMENT (CROSS PROGRAM RECOVERY PHASE 3)

We used (1) of (2) SSI benefits to recover some or all of an overpayment on this record.

Fill-in values:

 

Fill-in (1)

Deductions Additions History Amount (DAH-AMOUNT) that corresponds to the Deductions Additions History Type of Payment Code (DAH-TOP) = P and Deductions Additions History Item Code (DAH-ITEM) = 382 in the format $$$$$$.¢¢

Fill-in (2)

 

Choice 1

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)

Choice 2

your

OPT149 – TITLE XVI (SSI) UNDERPAYMENT NOT USED TO REDUCE OR RECOVERY A TITLE II OVERPAYMENT (CROSS PROGRAM RECOVERY PHASE 3)

We did not use any of (1) SSI benefits to recover an overpayment on this record.

Fill-in values:

 

Fill-in (1)

 

Choice 1

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)

Choice 2

your

OPT216 – OVERPAYMENT CAUSED BY SUBSTANTIAL GAINFUL WORK ACTIVITY (SGA) DURING THE EXTENDED PERIOD OF ELIGIBILITY (EPE) OR DISABILITY CESSATION DUE TO SGA

(1) received (2) too much in benefits because of (3) work activity. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

your

Choice 2

his

Choice 3

her

Choice 4

Number Holder’s Beneficiary Given Name (BGN) plus Beneficiary Last Name (BLN)

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT217 – OVERPAYMENT ESTABLISHED VIA CROSS PROGRAM RECOVERY (CPR) TO RECOVER A TITLE VIII SPECIAL VETERANS BENEFITS (SVB) PAID IN EXCESS

(1) received (2) too much in benefits because (3) received Special Veterans Benefit (SVB) payments. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you

Choice 2

he

Choice 3

she

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT218 – OVERPAYMENT CAUSED DUE TO INCORRECT PAYMENTS FOR MEDICARE SERVICES

(1) received (2) too much in benefits because of incorrect payments for Medicare services. Please read the rest of this letter carefully. In it, we explain the changes we made to (3) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT219 – OVERPAYMENT ESTABLISHED BECAUSE THE BENEFCIARY WAS CONVICTED OF A CRIME OR IMPRISONED FOR MORE THAN 30 DAYS DUE TO FELONIOUS HOMICIDE

(1) received (2) too much in benefits because (3) criminal conviction and imprisonment for more than 30 days. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

your

Choice 2

his

Choice 3

her

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT220 – OVERPAYMENT CAUSED BY WINDFALL OFFSET

(1) received (2) too much in benefits because (3) received Supplemental Security Income (SSI) payments (4) (5). Please read the rest of this letter carefully. In it, we explain the changes we made to (6) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you

Choice 2

he

Choice 3

she

Fill-in (4)

 

Choice 1

from

Choice 2

in

Fill-in (5)

 

Choice 1

Month CCYY through Month CCYY

Choice 2

Month CCYY

Fill-in (5)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT221 – OVERPAYMENT ESTABLISHED BECAUSE MORE THAN ONE PAYMENT WAS CASHED FOR THE SAME MONTH

(1) received (2) too much in benefits because we should not have paid two payments for the same month(s). Please read the rest of this letter carefully. In it, we explain the changes we made to (3) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT222 – OVERPAYMENT ESTABLISHED DUE TO INVALID FAMILY RELATIONSHIPS

(1) received (2) too much in benefits because (3) did not meet the relationship requirements to receive benefits. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you

Choice 2

he

Choice 3

she

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT223 – OVERPAYMENT ESTABLISHED BECAUSE OF INVALID ENTITLEMENT

(1) received (2) too much in benefits because (3) did not qualify for benefits. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you

Choice 2

he

Choice 3

she

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT224 – OVERPAYMENT ESTABLISHED BECAUSE THE BENEFICIARY WAS DEPORTED

(1) received (2) too much in benefits because (3) deported from the United States. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you were

Choice 2

he was

Choice 3

she was

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT225 – OVERPAYMENT ESTABLISHED DUE TO INCORRECT COMPUTATION, A LEGALLY DEFINED OVERPAYMENT OR TO RECOVER A SKELETON DUE PROCESS OVERPAYMENT

(1) received (2) too much in benefits because the payment amount was incorrect. We corrected (3) record, which caused (4) benefit amount to decrease. Please read the rest of this letter carefully. In it, we explain the changes we made to (5) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

your

Choice 2

his

Choice 3

her

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

Fill-in (5)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT226 – OVERPAYMENT ESTABLISHED DUE TO SUBVERSIVE ACTIVITY

(1) received (2) too much in benefits because (3) convicted of crimes against the United States. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you were

Choice 2

he was

Choice 3

she was

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT227 – OVERPAYMENT ESTABLISHED BECAUSE THE BENEFICIARY DID NOT HAVE A CHILD IN THEIR CARE

(1) received (2) too much in benefits because (3) a child in (4) care who receives benefits from us. Please read the rest of this letter carefully. In it, we explain the changes we made to (5) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you no longer have

Choice 2

he no longer has

Choice 3

she no longer has

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

Fill-in (5)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT229 – OVERPAYMENT ESTABLISHED BECAUSE A WARRANT FOR THE BENEFICIARY’S ARREST EXISTS

(1) received (2) too much in benefits. We should not have paid (3) because of a warrant for (4) arrest. Please read the rest of this letter carefully. In it, we explain the changes we made to (5) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you

Choice 2

him

Choice 3

her

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

Fill-in (5)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT230 – OVERPAYMENT ESTABLISHED BECAUSE OF STATE OR FEDERAL ASSISTANCE

(1) received (2) too much in benefits because (3) received State or Federal assistance. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you

Choice 2

he

Choice 3

she

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT231 – OVERPAYMENT CAUSED BY REPRESENTATIVE PAYEE MISUSE OF BENEFITS

(1) received (2) too much in benefits because (3) misused funds while acting as a representative payee. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you

Choice 2

he

Choice 3

she

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT232 – OVERPAYMENT CAUSED BY DISABILITY CESSATION

(1) received (2) too much in benefits because we cannot pay benefits after (3) disability ends. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you

Choice 2

he

Choice 3

she

Choice 4

Number Holder’s Beneficiary Given Name (BGN) plus Beneficiary Last Name (BLN)

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT234 – OVERPAYMENT ESTABLISHED DUE TO RECEIPT OF PROVISIONAL BENEFITS ON A CLAIM THAT WAS LATER DENIED

(1) received (2) too much in benefits because (3) you received temporary benefits while we were making a decision on (4) claim that we later denied. Please read the rest of this letter carefully. In it, we explain the changes we made to (5) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you

Choice 2

he

Choice 3

she

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

Fill-in (5)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT235 – OVERPAYMENT ESTABLISHED DUE TO CROSS-BENEFIT ADJUSTMENT

We moved (1) overpayment of (2) to (3) for collection. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

another person's

Choice 2

Number Holder’s Beneficiary Given Name (BGN) plus Beneficiary Last Name (BLN) (possessive)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT236 – OVERPAYMENT ESTABLISHED DUE TO CHANGE IN THE AMOUNT OR COMMENCEMENT OF THE GOVERNMENT PENSION OFFSET

(1) received (2) too much in benefits because we must offset (3) benefit payments due to (4) receipt of a government pension. Please read the rest of this letter carefully. In it, we explain the changes we made to (5) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

your

Choice 2

his

Choice 3

her

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

Fill-in (5)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT237 – OVERPAYMENT ESTABLISHED DUE TO RECEIPT OF A PENSION BASED ON WORK NOT COVERED BY SOCIAL SECURITY TAXES

(1) received (2) too much in benefits because (3) received a pension based on work not covered by Social Security taxes. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you

Choice 2

he

Choice 3

she

Choice 4

Wage Earner’s Name

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT238 – OVERPAYMENT ESTABLISHED DUE TO RECEIPT OF PAYMENTS AFTER CONFINEMENT TO A MENTAL INSTITUTION BECAUSE OF A COURT ORDER

(1) received (2) too much in benefits because (3) received payments after being confined to an institution because of a court order. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you

Choice 2

he

Choice 3

she

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT239 – OVERPAYMENT ESTABLISHED BECAUSE THE BENEFICIARY WAS AN ALIEN LIVING OUTSIDE THE UNITED STATES WHILE RECEIVING BENEFITS

(1) received (2) too much in benefits because (3) not a United States citizen and (4) outside the country for six months in a row. Please read the rest of this letter carefully. In it, we explain the changes we made to (5) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you are

Choice 2

he is

Choice 3

she is

Fill-in (3)

 

Choice 1

you were

Choice 2

he was

Choice 3

she was

Fill-in (5)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT240 – OVERPAYMENT ESTABLISHED BECAUSE THE BENEFICIARY WORKED OUTSIDE THE US IN A JOB NOT COVERED UNDER SOCIAL SECURITY TAXES

(1) received (2) too much in benefits because (3) you worked outside the United States in a job not covered by United States Social Security taxes. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you

Choice 2

he

Choice 3

she

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT241 – OVERPAYMENT ESTABLISHED DUE TO PRISONER SUSPENSION

(1) received (2) too much in benefits because of (3) criminal conviction and confinement in a correctional institution for more than 30 days. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

your

Choice 2

his

Choice 3

her

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT242 – OVERPAYMENT ESTABLISHED DUE TO DEATH RECLAMATION, REPRESENTATIVE PAYEE ELECTRONIC FUNDS TRANSFER (EFT) AFTER DEATH OR REPRESENTATIVE PAYEE DEATH

(1) received (2) too much in benefits because we cannot pay benefits for the month of death or later. Please read the rest of this letter carefully. In it, we explain the changes we made to (3) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT243 – OVERPAYMENT ESTABLISHED DUE TO PERMANENT DEDUCTIONS RESULTING FROM THE ANNUAL EARNINGS TEST

(1) received (2) too much in benefits because of (3) work and earnings. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

your

Choice 2

his

Choice 3

her

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT244 – OVERPAYMENT ESTABLISHED DUE TO DEATH SUPER-ENDORSEMENT

(1) received (2) too much in benefits because (3) signed and cashed a check for the month of death or later . Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you

Choice 2

he

Choice 3

she

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT245 – OVERPAYMENT ESTABLISHED DUE TO A CHANGE IN MARITAL STATUS

(1) received (2) too much in benefits because of a change in (3) marital status. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

your

Choice 2

his

Choice 3

her

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT246 – OVERPAYMENT ESTABLISHED DUE TO ENTITLEMENT TO WORKERS’ COMPENSATION, PUBLIC DISABILITY OR BOTH

(1) received (2) too much in benefits because of (3) receipt of workers’ compensation, pubic disability payments or both of these payments. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

your

Choice 2

his

Choice 3

her

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT247 – OVERPAYMENT ESTABLISHED BECAUSE THE BENEFICIARY CONTINUED TO RECEIVE BENEFITS AFTER THE AGE OF 18

(1) received (2) too much in benefits because we do not pay benefits once a student reaches age 18, unless he or she is a full time student elementary or high school student. Please read the rest of this letter carefully. In it, we explain the changes we made to (3) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT248 – OVERPAYMENT ESTABLISHED BECAUSE THE BENEFICIARY CONTINUED TO RECEIVE BENEFITS AFTER AGE 19 OR 22

(1) received (2) too much in benefits we do not pay benefits once a student reaches age 19 unless he or she is disabled. Please read the rest of this letter carefully. In it, we explain the changes we made to (3) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT249 – OVERPAYMENT ESTABLISHED BECAUSE THE BENEFICIARY IS NO LONGER IN FULL-TIME SCHOOL ATTENDANCE

(1) received (2) too much in benefits because we do not pay benefits once a student stops going to school full-time. Please read the rest of this letter carefully. In it, we explain the changes we made to (3) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT250 – OVERPAYMENT ESTABLISHED BECAUSE THE BENEFICIARY REFUSED TO ACCEPT VOCATIONAL REHABILITATION

(1) received (2) too much in benefits because we should not have paid benefits when (3) refused vocational rehabilitation services. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you

Choice 2

he

Choice 3

she

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT252 – OVERPAYMENT ESTABLISHED DUE TO UNPAID ATTORNEY FEES

(1) received (2) too much in benefits because of unpaid attorney’s fees. Please read the rest of this letter carefully. In it, we explain the changes we made to (3) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT253 – OVERPAYMENT ESTABLISHED RAILROAD RETIREMENT BOARD EARNINGS WERE INCORRECTLY USED TO ESTABLISH THE BENEFICARY’S ENTITLEMENT

(1) received (2) too much in benefits because (3) received incorrect payments from the Railroad Retirement Board. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you

Choice 2

he

Choice 3

she

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT254 – OVERPAYMENT ESTABLISHED BECAUSE THE BENEFICARY WAS NOT A UNITED STATES (U.S.) CITIZEN OR LAWFULLY PRESENT IN THE U.S.

(1) received (2) too much in benefits because (3) received payments even though (4) not a United States citizen or lawfully present in the U.S. Please read the rest of this letter carefully. In it, we explain the changes we made to (5) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you

Choice 2

he

Choice 3

she

Fill-in (4)

 

Choice 1

you were

Choice 2

he was

Choice 3

she was

Fill-in (5)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT255 – OVERPAYMENT ESTABLISHED BECAUSE THE MONTH OF ENTITLEMENT WAS INCORRECT

(1) received (2) too much in benefits because of a change in the month (3) benefits started. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

your

Choice 2

his

Choice 3

her

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT257 – OVERPAYMENT ESTABLISHED DUE TO MULTIPLE ENTITLEMENTS

(1) received (2) too much in benefits because (3) received payments on two or more records for the same month(s). Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you

Choice 2

he

Choice 3

she

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT258 – OVERPAYMENT ESTABLISHED BECAUSE INSURED STATUS WAS NOT MET

(1) received (2) too much in benefits because (3) worked long enough under Social Security to receive monthly benefits. Please read the rest of this letter carefully. In it, we explain the changes we made to (4) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you have not

Choice 2

he has not

Choice 3

she has not

Fill-in (4)

 

Choice 1

your

Choice 2

his

Choice 3

her

OPT259 – OVERPAYMENT ESTABLISHED BECAUSE THE BENFICIARY MISUSED FUNDS WHILE SERVING AS A REPRESENTATIVE PAYEE

(1) received (2) too much in benefits because (3) misused benefits that (4) received as the representative payee for another person. Please read the rest of this letter carefully. In it, we explain the changes we made to (5) benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

You

Choice 2

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Fill-in (2)

Overpayment amount in the format $$$$$.¢¢

Fill-in (3)

 

Choice 1

you

Choice 2

he

Choice 3

she

Fill-in (4)

 

Choice 1

you

Choice 2

he

Choice 3

she

Fill-in (5)

 

Choice 1

your

Choice 2

his

Choice 3

her


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900730130
NL 00730.130 - O Paragraphs and Captions - 08/16/2017
Batch run: 08/16/2017
Rev:08/16/2017