TN 15 (02-08)

Name

Address

Dear

You recently requested that we waive the collection of your overpayment of $ (1). Based on the facts we have now, we cannot approve your request. However, you have a right to meet with us before we decide if you have to pay back the overpayment. This meeting is called a personal conference. A person who has not made any decision about your waiver request will meet with you. We are writing to schedule this meeting.

You also have a right to review your file before the personal conference. We are scheduling a time for this meeting as well.

Some Important Dates

We have scheduled a time for you to review your file. This will help you get ready for your conference. You can review your file on (date and time), at the SSA office listed below. We will make sure that someone is available to help you when you come in for this review. You may bring a lawyer, friend, or someone else to help you review your file.

We have scheduled your personal conference for (date and time) at the same SSA office. You will meet with (name of interviewer) on that day.

If you prefer, the personal conference and folder review can be conducted by telephone or video teleconference. If you want to discuss these methods, please call (name of interviewer).

What Happens At a Personal Conference?

At the personal conference, you will meet with the person who will decide your case. You can tell this person why you think you should not have to pay us back. At the meeting, you can also do the following things.

• You can have a lawyer, friend, or someone else help you with your case.

• You can bring other people to help explain your case.

• You can review your file, and add any new facts you have.

• You can question the facts we have and the people who gave them.

Fill-in (2)

If You Have Any Questions

If you have any questions, or want to discuss the other means of conducting the personal conference and folder review, please call (name of interviewer) at (telephone number of interviewer) . If you cannot come in at the times scheduled, please let us know. We will arrange new dates and times.

Sincerely,

(Name)
Field Officer Manager

Fill-ins:

(1) The amount for which the person is liable minus any amount repaid to date

(2) If the person needs to submit verification of financial information, add:

“You need to show us proof of your monthly income, expenses, and assets. Examples are pay stubs, pension records, rent receipts, utility bills, and bank statements.”