POMS Reference

NL: Notices, Letters and Paragraphs

TN 4 (02-95)

EXAMPLE

The recipient began to receive income based on need last month and also receives a Department of Veterans Affairs (DVA) pension. The recipient has an overpayment that we are in the process of recovering. There will still be an overpayment balance remaining after the next check is issued.

The recipient's ineligible spouse receives title II income and a DVA pension based on need. Because the spouse receives a DVA pension based on need, the spouse's income does not affect the payment. As a result, the notice gives only the amount of the spouse's total income along with a statement that this income does not affect the recipient's payment.

NOTE: We included the numbers of the paragraphs we used in this notice in the left margin.

Example: Completed Field Office Manually Prepared Versions of the SSA-L8155-U2

G-NL 00803.040-1

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Example: Completed Field Office Manually Prepared Version of the SSA-L8155-U2

G-NL 00803.040-2

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Example - Completed Field Office Manually Prepared Version of the SSA-L8155-U2

G-NL 00803.040-3

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