NL: Notices, Letters and Paragraphs
TN 30 (03-96)
Document Identifier for Word Processor: E3151
A. Exhibit Letter
We are writing to tell you that we plan to reduce (1) Social Security benefits as a (2) because we learned that (3) (4) a government pension. Based on the information we have, we should have reduced the Social Security benefits beginning (5) .
The Information We Have
When we matched computer records with the Office of Personnel Management, we learned the following information about (6) pension.
| Monthly Payment(s) | Effective Date(s) |
|---|---|
| $ (7) | (8) |
Please read the enclosed fact sheet, “Government Pension Offset.” This fact sheet will give you more information about how (9) benefits may change.
What You Can Do
We cannot use this information to change (10) Social Security benefits until we give you time to check it. Certain information could change our plan to reduce (11) benefits. Please let us know right away if:
Any of the information we have about (12) government pension is wrong.
(13) eligible for a government pension before December 1982, even if (14) did not receive any payments before December 1982.
(15) eligible for a government pension before July 1983 AND (16) receiving one-half of (17) financial support from (18) at the time (19) retired, became disabled or died.
-
(20) paying Social Security (FICA) taxes on (21) federal salary before (22) retired.
If We Do Not Hear From You
If we do not hear from you within 30 days from the date of this letter, we will assume the information in this letter is correct and use it to reduce (23) Social Security benefits.
We will send another letter at that time. It will explain the change in (24) benefits, the amount of any overpayment, and how to appeal our decision.
You will have 60 days to ask for an appeal.
-
The 60 days will start the day after you receive the next letter.
If You Have Any Questions
3901C - Domestic
3901D - Foreign
Enclosure:
SSA Pub. No. 05-10007
B. Requesting Instructions
The PC will send this notice to a beneficiary in current pay status whose benefit will be reduced because of receipt of a government pension.
Refer to NL 00703.005E for 3901C and 3901D text and fill-ins.
Fill-ins:
your/full name of auxiliary beneficiary, possessive
spouse/divorced spouse/widow/surviving divorced spouse/widower
you/he/she
receive/receives/received an increase in
month and year that pension began or changed
your/auxiliary beneficiary's title and surname, possessive
amount(s) of pension
effective month(s) and year(s) of pension
your/his/her
your/auxiliary beneficiary's title and surname, possessive
your/his/her
your/his/her
you were/he was/she was
you/he/she
you were/he was/she was
you were/he was/she was
your/his/her
your spouse/your former spouse/his spouse/his former spouse/ her spouse/her former spouse
he/she
you were/he was/she was
your/his/her
you/he/she
your/auxiliary beneficiary's title and surname, possessive
your/his/her
C. Typing Instructions
Use Form SSA-L2000-C2 (Universal Notice) and follow the notice standards. Information for this notice will be shown on Form SSA-573.