We previously notified you that you were overpaid. The amount we must recover is now $*F1. This takes into account the additional $*F2 due you for *F3. (E3116.1)

Since monthly benefits are now payable to you, we are recovering the overpayment by withholding 10 percent of your benefit beginning with the payment you will receive about *F1. We will continue to withhold 10 percent of your benefit until the overpayment has been fully recovered. (3116A)

Or

Since monthly benefits are now payable to you, we are recovering the overpayment from the payment you would normally receive about *F1. The reduced payment will be $ *F2 and you will receive your regular monthly payment about *F3. (3116B)

Or

Since monthly benefits are now payable to you, we are recovering the overpayment by withholding 10 percent of your benefit beginning with the payment you will receive on or about *F1. We will continue to withhold 10 percent of your benefit until the overpayment has been fully recovered. The minimum we will withhold is $10. If the total benefit is less than $10, we will withhold the entire benefit. (3116C)

Call us at 1-800-772-1213 if the planned withholding of your payment will cause hardship or you prefer to refund the overpayment balance so that withholding of your payment is not necessary. (3116D)

If the planned withholding of *L benefit will cause hardship or if you prefer to make a full refund of the overpayment so that further withholding of *L payment will not be necessary, please contact *L.

You can contact us even if you do not want to request a waiver or a hearing. Please take this letter with you if you do visit an office. (3119D)

Suspect Social Security Fraud?

Please visit http://oig.ssa.gov/r or call the Inspector General's Fraud Hotline at 1-800-269-0271 (TTY 1-866-501-2101).

If You Have Any Questions

We invite you to visit our website at www.socialsecurity.govv on the Internet to find general information about Social Security. If you have any specific questions, you may call us toll-free at 1-800-772-1213, or call your local Social Security office at 1-*F3- *F4- *F5. We can answer most questions over the phone. If you are deaf or hard of hearing, you may call our TTY number, 1-800-325-0778. You can also write or visit any Social Security office. The office that serves your area is located at:

*F6

*F7

*F8

*F9 *F10- *F11

If you do call or visit an office, please have this letter with you. It will help us answer your questions. Also, if you plan to visit an office, you may call ahead to make an appointment. This will help us serve you more quickly when you arrive at the office. (CTDO Domestic)

The person who decides the overpayment can be adjusted (generally the benefit authorizer) is responsible for requesting this notice and providing the appropriate fill-ins.

• •

  Use 3116A if the overpayment exceeds the monthly payment.

• •

  Use 3116C if the overpayment equals the monthly payment.

• •

  Use 3116B if the overpayment is less than the monthly payment.

• •

  Use 3116D and CTDO for domestic cases.

• •

  Use 3119D if the person lives outside the U.S.

Fill-ins:

E3116.1:

*F1-1 amount of overpayment

*F2-1 amount of underpayment

*F3-1 months

3116A:

*F1-1 MM/DD/CCYY date payment will be received

3116B:

*F1-1: MM/DD/CCYY date payment will be received

*F2-1 amount of payment

*F3-1 MM/DD/CCYY date payment will be received

3116C:

*F1-1 MM/DD/CCYY date payment will be received

3119D:

*F1-1 your

*F1-2 his

*F1-3 her

*F2-1 your

*F2-2 his

*F2-3 her

*F3-1 your nearest Social Security office

*F3-2 the Social Security office that services your area in Canada. To find which office services your area, visit www.ssa.gov/foreign/canada.htm online

*F3-3 your nearest Federal Benefits Unit (FBU). Visit www.ssa.gov/foreign/foreign.htm for a list of FBUs

CTDO (Domestic) Fill-Ins:

*F1-1 Zip code

*F2-1 Zip+4

*F2-2 DO Code

*F3-1 Telephone Area Code

*F4-1 Phone Exchange

*F5-1 Phone Number

*F6-1 Local Office Address Line #1

*F7-1 Local Office Address Line #2

*F8-1 Local Office Address Line #3

*F9-1 City & State of Local Office

*F10-1 Local Office Zip code

*F11-1 Zip+4 of Local Office

Because the fill-ins may vary according to the different situations, follow the requester's typing instructions carefully.