We sent you $ (1) more in Social Security benefits for (2) than we should have.
(3) .
As representative payee, you are personally liable for repayment unless you used the
overpaid funds for the benefit of (4) and the overpayment was made through no fault of your own.
How To Pay Us Back
3111A |
You should refund this overpayment within 30 days. Please make your check or money
order payable to “Social Security Administration,” and send it to us in the enclosed envelope. Always include your claim number (as
shown above) on your check or money order.
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Please send your check or money order in United States currency or in local currency
equal to the United States dollars. When you pay us in local currency, we use the
exchange rate in effect at the time we get your payment. If this causes a difference
between the amount you pay us and the amount you owe us, we will let you know. If
you cannot mail your payment directly to us, please go to the nearest United States
Embassy or consulate for help in making the refund.
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If we do not receive your refund within 30 days, we plan to recover the overpayment
by withholding (1) full benefit beginning with the payment (2) about (3) . We will continue withholding (4) benefit until the amount we have kept is equal to the amount owed us.
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OR
3104B
or
3110B
If You Think You Should Not Have To Pay Us Back
3100C
If You Disagree With The Decision
3108B
Enclosures (2):
SSA-3105
Refund envelope
If the overpayment is less than the monthly payment, omit the refund envelope.