BASIC (04-14)

NL 03001.035 Double Check Negotiation Notice, One Check was Forged and Overpayment Incorrectly Recovered

A. When to use notice

Use this notice to inform a beneficiary or recipient when we know that one of the two checks we sent for the same month was forged, and we mistakenly recovered the overpayment amount from them.

B. Double check negotiation notice, one check was forged and overpayment incorrectly recovered

We sent [1] two checks for [2], both in the amount of $[3] and both were cashed. [4] and one by someone else cashed one. Since [5] only received one check, we should NOT have held back $[6] from [7] regular monthly payment. You will soon receive a payment for $[8], which is the money you are due.

If you have any questions, call us toll free at 1-800-772-1213 [9]. We can answer most questions over the phone. You can also write or visit any Social Security office.

The office that serves your area is:

  • District Office Address City, State Zip

If you do call or visit an office, please have this letter with you. It will help us answer your questions. If you plan to visit an office, you should call ahead to make an appointment. This will help us serve you more quickly.

Fill-ins:

  

[1]

Choice 1 -
Choice 2 -

you
Name of payee, in format: John Smith

[2]

 

Month and year, in format: May 2011

[3]

 

Amount of payment

[4]

Choice 1 -
Choice 2 -

you
person's title and last name, in format: Mr. Smith

[5]

Choice 1 -
Choice 2 -

you
person's title and last name, in format: Mr. Smith

[6]

 

Dollar amount held back

[7]

 

your/his/her

[8]

 

refund for dollar amount erroneously held back

[9]

 

or call your local Social Security office at (field office phone number is taken from the DOORS).


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0903001035
NL 03001.035 - Double Check Negotiation Notice, One Check was Forged and Overpayment Incorrectly Recovered - 04/18/2014
Batch run: 04/18/2014
Rev:04/18/2014