We are changing the amount of your check. The new amount is (1). You will receive this amount until we finish work on your claim.

Fill-in: (1) Show the new amount in the format $$$$¢¢

We are sending you a check for (1). This includes benefits due you through (2). After that, you'll get a check each month for (3). You will also get your regular check.

Fill-ins:

1. (1) 

   Show check amount in the format $$$$¢¢

2. (2) 

   Show the date in the format MM/YY

3. (3) 

   Show monthly check amount in the format $$$$¢¢

We are sending you a check for (1). This includes benefits due you through (2). After that, you'll get a check each month for (3).

Fill-ins:

1. (1) 

   Show check amount in the format $$$$¢¢

2. (2) 

   Show date in the format MM/YY

3. (3) 

   Show monthly check amount in the format $$$$¢¢

We are sending you a check for (1). This includes benefits due you through (2).

Fill-ins:

1. (1) 

   Show the check amount in the format $$$$¢¢

2. (2) 

   Show date in the format MM/YY

We have not finished the work on your claim at this time. Because of this, we may be paying you too much money.

If we do pay you too much, you may have to pay back the amount of the overpaid check(s) (1) or (2).

Fill-ins:

1. (1) 

   period (.)

2. (2) 

   or we may have to hold back some of your future benefits.

We have not finished the work on your claim at this time. Because of this, you may get more than one check. If you do, please let us know right away. We may be paying you too much money.

The check for (1) will continue until we finish our work on your claim. This check (2)

Fill-ins:

1. (1) 

   Show check amount in the format $$$$¢¢

2. (2) 

   Choice 1 - is based on your entitlement to disability benefits; or

   Choice 2 - is based on your entitlement to spouse's benefits; or

   Choice 3 - is the difference in the amount you have been receiving

   and the amount you are due.

As soon as we can, we will add the (1) to your regular monthly check. Then, we will send you a letter explaining your new benefit amount. The monthly checks of (2) should then stop. If they continue, please let us know right away. We may be paying you too much money.

Fill-ins:

1. (1) 

   Show the amount to be added in the format $$$$¢¢

2. (2) 

   Show the monthly checks in the format $$$$¢¢

When we finish our work on your claim, we will send you a letter explaining your benefit amount. If you receive more than one check for the same month(s), please let us know right away. We may be paying you too much money.

If you have any questions, please contact one of the following offices:

If you live in the United States, British Virgin Islands, Canada or Western Samoa, contact any Social Security Office.

If you live in Mexico, contact any Social Security Office or the nearest United States Embassy or consulate.

If you live in the Philippines, contact:

In all other countries get in touch with the nearest United States Embassy or consulate.

Regardless of where you live, you may write to:

If you write, please include your claim number. If you visit an office, please bring this notice. It will help us answer your questions.

If you have any questions, please call, write or visit any Social Security Office. If you write, please include your claim number. If you visit an office, please bring this notice. It will help us answer your questions.