NL 00720.295:
RFU Refund
Effective Dates: 09/17/2013 - Present- Effective Dates: 06/28/2018 - Present
TN 2 (09-11)- TN 9 (06-18)
- NL 00720.295 RFU Refund
- RFU001 REQUEST FOR REFUND - OVERPAID PERSON IN NONPAY STATUS NO CROSS PROGRAM ADJUSTMENT POSSIBLE (A19) (G13)
- (Requested/Generated)
- Caption: How To Pay Us Back
You should refund this overpayment within 30 days. Please make your check or money order payable to "Social Security Administration," and send it to us in the enclosed envelope. Include (1) claim number (as shown above) on your check or money order.- You should refund this overpayment of (1) within 30 days. Please make your check or money order payable to “Social Security Administration,” and send it to us in the enclosed envelope. Always include (2) Social Security claim number on your check or money order.
If you cannot refund the full (2) now, please send:- If you cannot refund the full (3) now, please send:
- * A partial payment
- * An explanation of why you cannot pay the full amount now, and
* A plan to replay the money- * A plan to repay the money
- Fill-in values:
Fill-in (1) - Systems Generated- Fill-in (1) – Systems Generated (when it is not requested on the ENB) or Requested As A Money Amount in Format $$$$$.¢¢
- Overpayment Amount
- Fill-in (2) Systems Generated
- Choice 1: your
- Choice 2: his
- Choice 3: her
Fill-in (2) - Requested As A Money Amount in Format $$$$$.¢¢- Fill-in (3) Systems Generated (when it is not requested on the ENB) Requested As A Money Amount in Format $$$$$.¢¢
- Overpayment Amount
- RFU003 REQUEST FOR REFUND AND ADJUSTMENT PROPOSED - OVERPAID PERSON IN NONPAY STATUS AND IS REPRESENTATIVE PAYEE FOR OTHER - OVERPAYMENT EXCEEDS MONTHLY PAYMENT (A26)
- (Requested)
- Caption: How To Pay Us Back
You should refund this overpayment within 30 days. Please make your check or money order payable to "Social Security Administration," and send it to us in the enclosed envelope. Always include your claim number (as indicated above) on the check or money order. If you cannot refund the full (1) now, you should submit: (a) a partial payment; (b) an explanation of your financial circumstances; and (c) a definite plan for repaying the balance.- You should refund this overpayment of (1) within 30 days. Please make your check or money order payable to “Social Security Administration,” and send it to us in the enclosed envelope.
- Always include (2) Social Security claim number on your check or money order.
If we do not receive your refund within 30 days, we plan to recover the overpayment by withholding (2) full benefit beginning with the payment you would normally receive for (3) about (4) . We will continue withholding the benefit you receive for (5) until the overpayment has been fully recovered.- If we do not receive your refund within 30 days, we will hold back (3) full benefit starting with the payment you would normally receive (4) about
- (5) . We will continue holding back (6) benefits until we recover the overpayment.
- If you cannot refund the full overpayment now or cannot afford to have us hold back (7) full benefit, you may ask us to hold back a smaller amount each month. Contact us to discuss your plan for repaying the balance. You may need to show us proof of (8) assets, monthly income, and expenses.
- Fill-in values:
Fill-in (1) Requested As A Money Amount in Format $$$$$.¢¢- Fill-in (1) Systems Generated
Amount- Amount of Overpayment
Fill-in (2) Requested As a Language- Fill-in (2) Systems Generated
First Name(s) of the BIC(s)- Choice 1: your
Fill-in (3) Requested As A One Position Alpha Character- Choice 2: his
Choice 1: (A) him- Choice 3: her
Choice 2: (B) her- Fill-in (3) Systems Generated
Choice 3: (C) them- Choice 1: your
Fill-in (4) Requested As A Date In Format Shown Below- Choice 2: his
- Choice 3: her
- Fill-in (4) Systems Generated
- Choice 1: NULL
- Choice 2: for him
- Choice 3: for her
- Fill-in (5) Systems Generated
- MM/DD/CCYY
Fill-in (5) Requested As A One Position Alpha Character- Fill-in (6) Systems Generated
Choice 1: (A) him- Choice 1: your
Choice 2: (B) her- Choice 2: his
Choice 3: (C) them- Choice 3: her
- Fill-in (7) Systems Generated
- Choice 1: your
- Choice 2: his
- Choice 3: her
- Fill-in (8) Systems Generated
- Choice 1: your
- Choice 2: his
- Choice 3: her
- RFU007 SSI OFFSET NOT APPLICABLE (A59)
- (Requested)
- Caption: Your Benefits
- Our records show that (1) did not get SSI money for (2) . So we can refund all of the Social Security money we held.
- Fill-in values:
- Fill-in (1) Systems Generated
- Choice 1: you
- Choice 2: Beneficiary's Name
- Fill-in (2) Requested As A Date In Format Shown Below
- Choice 1: MM/CCYY
- Choice 2: MM/CCYY through MM/CCYY
- RFU008 REFUND/RETURNED CHECK(S) USED TO REDUCE OVERPAYMENT (A34)
- (Requested)
- Caption: Your Benefits
- We used the amount refunded to replace (1) the money we (2) (3) .
- Fill-in values:
- Fill-in (1) Requested As A One Position Alpha Character
- Choice 1: (A) some of
- Choice 2: (B) null
- Fill-in (2) Requested As A One Position Alpha Character
- Choice 1: (A) incorrectly paid
- Choice 2: (B) overpaid
- Fill-in (3) Systems Generated
- Choice 1: you
- Choice 2: him
- Choice 3: her
- Choice 4: Beneficiary's Name
- RFU012 REQUEST FOR REFUND AND ADJUSTMENT PROPOSED — OVERPAID PERSON IN CURRENT PAY — OVERPAYMENT EXCEEDS MONTHLY PAYMENT (A24)
- (Requested/Generated)
- Caption: How To Pay Us Back
You should refund this overpayment of (1) within 30 days. Please make your check or money order payable to "Social Security Administration," and send it to us in the enclosed envelope. Include (2) claim number (as shown above) on your check or money order.- You should refund this overpayment of $ (1) within 30 days. Please make your check or money order payable to “Social Security Administration,” and send it to us in the enclosed envelope.
- Always include (2) Social Security claim number on your check or money order.
If we do not receive your refund within 30 days, we will hold back (3) full benefit starting with the payment you would normally receive (4) about (5) . We will continue holding back (6) benefits until we recover the overpayment.- If we do not receive your refund within 30 days, we will hold back (3) full benefit starting with the payment you would normally receive (4) about
If you cannot refund the full overpayment now or cannot afford to have us hold back (7) , full benefit, you may ask us to hold back a smaller amount each month. Contact us to discuss your plan for repaying the balance. You may need to show us proof of (8) assets, monthly income, and expenses.- (5) . We will continue holding back (6) benefits until we recover the overpayment.
- If you cannot refund the full overpayment now or cannot afford to have us hold back (7) full benefit, you may ask us to hold back a smaller amount each month. Contact us to discuss your plan for repaying the balance. You may need to show us proof of (8) assets, monthly income, and expenses.
- Fill-in values:
Fill-in (1) - Requested As A Money Amount in Format $$$$$.¢¢- Fill-in (1) - Systems Generated (when it is not requested on the ENB) Requested As A Money Amount in Format $$$$$.¢¢
- Overpayment Amount
- Fill-in (2) - Systems Generated
- Choice 1: your
- Choice 2: his
- Choice 3: her
- Fill-in (3) - Systems Generated
- Choice 1: your
- Choice 2: his
- Choice 3: her
- Fill-in (4) - Systems Generated
- Choice 1: null
- Choice 2: for him
- Choice 3: for her
Fill-in (5) - Requested As A Date In Format Shown Below- Fill-in (5) - Systems Generated (when it is not requested on the ENB) Requested As A Date In Format Shown Below
MM/DD/YYYY- MM/DD/CCYY
- Fill-in (6) - Systems Generated
- Choice 1: your
- Choice 2: his
- Choice 3: her
- Fill-in (7) - Systems Generated
- Choice 1: your
- Choice 2: his
- Choice 3: her
- Fill-in (8) - Systems Generated
- Choice 1: your
- Choice 2: his
- Choice 3: her
- RFU020 FOREIGN REFUND REQUEST NONPAY STATUS (F19)
- Caption: How To Pay Us Back
- (System Generated)
You should refund this overpayment within 30 days. Please make your check or money order payable to "Social Security Administration," and send it to us in the enclosed envelope. Always include (1) claim number (as indicated above) on the check or money order. If you cannot refund the full (2) now, you should submit:a. partial payment,- You should refund this overpayment within 30 days. Please make your check or money order payable to “Social Security Administration,” and send it to us in the enclosed envelope. Always include (1) Social Security claim number on the check or money order. If you cannot refund the full (2) now, you should submit:
- * partial payment,
- * an explanation of your financial circumstances, and
- * a definite plan for repaying the balance.
b. an explanation of your financial circumstances, andc. a definite plan for repaying the balance. If you pay us by check or money order, make sure that the check or money order is in United States (U.S.) dollars or in local currency equal to U.S. dollars. When you pay us in local currency, we use the exchange rates in effect at the time we get your payment. If this causes a difference between the amount you pay us and the amount you owe us, we will let you know. If you cannot mail your payment to us, please go to the nearest U.S. Embassy or consulate. They will help you make the refund.- If you pay us by check or money order, make sure that the check or money order is in United States (U.S.) dollars or in local currency equal to U.S. dollars. When you pay us in local currency, we use the exchange rates in effect at the time we get your payment. If this causes a difference between the amount you pay us and the amount you owe us, we will let you know. If you cannot mail your payment to us, please contact your Federal Benefits Unit. Visit (3) for a list of Federal Benefits Units. They will help you make the refund.
- Fill-in values:
Fill-in (1)- Fill-in (1) Systems Generated
- Choice 1: Beneficiary's name possessive
- Choice 2: your
Fill-in (2)- Fill-in (2) Systems Generated
- Overpayment amount in $$$$$¢¢
- Fill-in (3) Systems Generated
- www.socialsecurity.gov/foreign/foreign.htm
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