TN 24 (12-94)
1040. Situation Where Used:
Advance payment collected from retroactive payment due, and additional retroactive
payment is due.
After taking into account the (1) advanced to (you) (2) against (your) benefits. (3) is the rest of the payment due (you) (4) .
| (1) |
$$$.¢¢ |
| (2) |
Choice 1 - in (Month/Year) |
| |
Choice 2 - Null |
| (3) |
$$$.¢¢ |
| (4) |
Choice 1 - for (Month/Year) |
| |
Choice 2 - for (Month/Year) through (Month/Year) |
1041. Situation Where Used:
Advance payment collected from retroactive payment and part of a monthly payment.
Use fill-in 5 only if the individual has a prior overpayment which also must be repaid.
No payment is due (you) at this time since (you) received an advance payment of (1) against these benefits (2) . (3) . Based on the information we have now, (you) will
(4) .
| (1) |
$$$.¢¢ |
| (2) |
Choice 1 - |
in (Month/Year) |
| |
Choice 2 - |
Null |
| (3) |
Choice 1 - |
As we previously notified (you) , (you) were overpaid when
(you) formerly received Supplemental Security Income payments. (You) must still repay $$$.¢¢ of this overpayment.
|
| |
Choice 2 - |
Null |
| (4) |
Choice 1 - |
not receive any additional payment |
| |
Choice 2 - |
receive a payment of $$$.¢¢ for (Month/Year) and $$$. ¢¢ for (Month/Year) |
| |
Choice 3 - |
receive (your) full monthly payment amount beginning (Month/Year)
|
| |
Choice 4 - |
receive a payment of $$$.¢¢ for (Month/Year) and (your) full monthly payment amount thereafter
|
1043. Situation Where Used:
Advance payment was not completely collected from retroactive payment and individual
is currently ineligible—no ongoing money is due.
(You) have been overpaid (1) because we gave (you) an advance payment of (2) (3) and (you) are eligible to receive only (4) (5) .
| (1) |
$$$.¢¢ |
| (2) |
$$$.¢¢ |
| (3) |
Choice 1 - in (Month/Year) |
| |
Choice 2 - Null |
| (4) |
$$$.¢¢ |
| (5) |
Choice 1 - for (Month/Year) |
| |
Choice 2 - for (Month/Year) through (Month/Year) |
1044. Situation Where Used:
One-time payment exceeded amount due. Retroactive payment cannot be made, but ongoing
payment must be made. Overpayment to be collected.
(You) have been overpaid (1) because we paid (you) (2) (3) and (you) were eligible to receive (4) for that (5) .
| (1) |
$$$.¢¢ |
| (2) |
$$$.¢¢ |
| (3) |
Choice 1 - for (Month/Year) |
| |
Choice 2 - for (Month/Year) through (Month/Year) |
| (4) |
Choice 1 - $$$.¢¢ only |
| |
Choice 2 - no payment |
| (5) |
Choice 1 - month |
| |
Choice 2 - period |
1048. Situation Where Used:
Advance payment not completely offset by retroactive payment. One-time payments and/or
presumptive disability payments completely offset. Use fill-in 8 if there is also
an overpayment from a prior record which must be collected.
No payment is due (you) at this time. (You) received an advance payment of (1) against these benefits (2) , and (you) received other payments of (3) (4) . Since (you) were due only (5) for this (6) , (you) have received (7) more than (you) were due. (8) (9)
| (1) |
$$$.¢¢ |
| (2) |
Choice 1 - |
in (Month/Year) |
| |
Choice 2 - |
Null |
| (3) |
$$$.¢¢ |
| (4) |
Choice 1 - |
for (Month/Year) |
| |
Choice 2 - |
for (Month/Year) through (Month/Year) |
| (5) |
$$$.¢¢ |
| (6) |
Choice 1 - |
month |
| |
Choice 2 - |
period |
| (7) |
$$$.¢¢ |
| (8) |
Choice 1 - |
As we previously notified (you) , (you) were also overpaid when (you) formerly received Supplemental Security Income payments. (You) must still repay $$$.¢¢ of this overpayment. Beginning (Month/Year) we will withhold
$$$.¢¢ from (your) monthly payments until the overpayment has been repaid.
|
| |
Choice 2 - |
Null |
| (9) |
Choice 1 - |
Based on the information we have now, (you) will receive (your) full monthly payment amount beginning (Month/ Year).
|
| |
Choice 2 - |
Based on the information we have now, (you) will receive a payment amount of $$$.¢¢ for (Month/Year) and (your) full monthly payment thereafter.
|
| |
Choice 3 - |
Based on the information we have now, (you) will receive a payment of $$$.¢¢ for (Month/Year) and of $$$.¢ ¢ for (Month/Year).
|
| |
Choice 4 - |
Null |
1049. Situation Where Used:
Preceded by paragraph 1484 which refers to the amount of the advance payment. Used
when ongoing payment is due, advance payment is not completely offset by retroactive
payment, and one-time payment or presumptive disability payment is not completely
offset by retroactive payment.
In addition, (you) have been overpaid (1) because we gave (you) payments of (2)
(3) , and (you) were eligible to receive only (4) for that (5) .
| (1) |
$$$.¢¢ |
| (2) |
$$$.¢¢ |
| (3) |
Choice 1 - for (Month/Year) |
| |
Choice 2 - for (Month/Year) through (Month/Year) |
| (4) |
$$$.¢¢ |
| (5) |
Choice 1 - month |
| |
Choice 2 - period |
1483. Situation Where Used:
Advance payment recovered from retroactive payment—no additional retroactive payment
due.
Because (you) already received an advance payment of (1) (2) , (you) are not due any more money (3) .
| (1) |
$$$.¢¢ |
| (2) |
Choice 1 - in (Month/Year) |
| |
Choice 2 - Null |
| (3) |
Choice 1 - for (Month/Year) |
| |
Choice 2 - for (Month/Year) through (Month/Year) |
1484. Situation Where Used:
Precedes paragraph 1049 to show the amount of advanced payment per month for a past
period and the remainder due per month for that period. It is used when: (1) ongoing
payment is due; (2) the advanced payment is not completely collected from retroactive
payments, and (3) OTP's or presumptive disability payments are not completely collected
from retroactive payments.
Also used when there was no advance payment. Presumptive disability payments or OTP's
were paid, completely offset, and there is retroactive money payable.
Because we already paid (you) (1) (2) , (3) is the rest of the payment due (you)
(4) .
| (1) |
$$$.¢¢ |
| (2) |
Choice 1 - for (Month/Year) |
| |
Choice 2 - for (Month/Year) through (Month/Year) |
| |
Choice 3 - in advance |
| (3) |
$$$.¢¢ |
| (4) |
Choice 1 - for that month |
| |
Choice 2 - for that period |
| |
Choice 3 - for (Month/Year) |
2040. Situation Where Used:
Payment amount is adjusted; advance payment is being recovered by withholding.
However, no check is due (you) at this time because of the advance payment of (1) which (you) received from (your) local Social Security office. (2)
| (1) |
$$$.¢¢ |
| (2) |
Choice 1 - |
Based on the information we have now, (you) will receive $$$.¢¢ per month beginning (Month/Year).
|
| |
Choice 2 - |
Based on the information we have now, (you) will receive a payment of $$$.¢¢ for (Month/Year) and (your) full monthly payment amount of $$$.¢¢ thereafter.
|
| |
Choice 3 - |
We will let you know as soon as payment can be made. |
2041. Situation Where Used:
An overpayment (may be combination of advance payment and overpayment) is being recovered
by monthly deduction. Another event causes a decrease/ increase and the amount due
is equal to or less than the amount being recovered. (Recipient will not be sent a
monthly payment but is not in suspense.)
However, because you previously received excess payments and still owe (1) , no check is due (you) at this time. (2)
| (1) |
$$$.¢¢ |
| (2) |
Choice 1 - |
Based on the information we have now, (you) will receive $$$.¢¢ per month beginning (Month/Year).
|
| |
Choice 2 - |
Based on the information we have now, (you) will receive a payment of $$$.¢¢ for (Month/Year) and (your) full monthly payment amount of $$$.¢¢ thereafter.
|
| |
Choice 3 - |
We will let you know as soon as payment can be made. |
2043. Situation Where Used:
Only the ongoing check is due. Since we have recovered the advance payment, we are
now paying the full amount due.
Since the advance payment against (your) Supplemental Security Income has been fully accounted for, we (1) .
| (1) |
Choice 1 - |
will send (your) regular monthly check to you about the first day of the month
|
| |
Choice 2 - |
will send (your) regular monthly check to (your) bank or other financial institution about the first day of the month
|
| |
Choice 3 - |
are sending (you) a check for $$$.¢¢ for the month of (Month). This check should be received about
the first of the month. After that, (your) check will be for (your) regular monthly payment amount
|
| |
Choice 4 - |
are sending (your) bank or other financial institution a check for $$$.¢¢ for the month of (Month).
This check should be received about the first of the month. After that, (your) check will be for (your) regular monthly payment amount
|