TN 3 (05-92)

NL 00803.140 Completed Field Office Manually Prepared Version of the SSA-L8171-U3 Notice of Overpayment

EXAMPLE

This Notice of Overpayment requests refund from a recipient in current pay who is a resident of a title XIX medical care facility.

NOTE: We included the numbers of the paragraphs we used in this notice in the left margin.

Example: Completed Field Office Manually Prepared Version of the SSA-L8171-U3 Notice of Overpayment

G-NL 00803.140-1

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Example: Completed Field Office Manually Prepared Version of the SSA-L8171-U3 Notice of Overpayment

G-NL 00803.140-2

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Example: Completed Field Office Manually Prepared Version of the SSA-L8171-U3 Notice of Overpayment

G-NL 00803.140-3

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Example: Completed Field Office Manually Prepared Version of the SSA-L8171-U3 Notice of Overpayment

G-NL 00803.140-4

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Example: Completed Field Office Manually Prepared Version of the SSA-L8171-U3 Notice of Overpayment

G-NL 00803.140-5

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To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900803140
NL 00803.140 - Completed Field Office Manually Prepared Version of the SSA-L8171-U3 Notice of Overpayment - 04/07/1999
Batch run: 01/27/2009
Rev:04/07/1999