This notice tells a former recipient that we waived part, but not all, of the overpayment. Since the notice is to a former recipient, it follows the format of the SSA-L8174-U3 to tell the individual about the part of the overpayment that was not waived and to request refund.

Example: Completed Field Office Manually Prepared Version of the SSA-L8165-U2 Important Information

Example: Completed Field Office Manually Prepared Version of the SSA-L8165-U2 Important Information

Example: Completed Field Office Manually Prepared Version of the SSA-L8165-U2 Important Information