We are writing to tell you that we plan to reduce (1) Social Security benefits as a (2) because we learned that (3) (4) a government pension. Based on the information we have, we should have reduced the
Social Security benefits beginning (5) .
The Information We Have
When we matched computer records with the Office of Personnel Management, we learned
the following information about (6) pension.
| Monthly Payment(s) |
Effective Date(s) |
| $ (7) |
(8) |
Please read the enclosed fact sheet, “Government Pension Offset.” This fact sheet will give you more information about how (9) benefits may change.
What You Can Do
We cannot use this information to change (10) Social Security benefits until we give you time to check it. Certain information
could change our plan to reduce (11) benefits. Please let us know right away if:
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Any of the information we have about (12) government pension is wrong.
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(13) eligible for a government pension before December 1982, even if (14) did not receive any payments before December 1982.
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(15) eligible for a government pension before July 1983 AND (16) receiving one-half of (17) financial support from (18) at the time (19) retired, became disabled or died.
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(20) paying Social Security (FICA) taxes on (21) federal salary before (22) retired.
If We Do Not Hear From You
If we do not hear from you within 30 days from the date of this letter, we will assume
the information in this letter is correct and use it to reduce (23) Social Security benefits.
We will send another letter at that time. It will explain the change in (24) benefits, the amount of any overpayment, and how to appeal our decision.
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You will have 60 days to ask for an appeal.
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The 60 days will start the day after you receive the next letter.
If You Have Any Questions
3901C - Domestic
3901D - Foreign
Enclosure:
SSA Pub. No. 05-10007