TN 3 (05-92)

A. DESCRIPTION

1. General

The SSA-L8176-U2 is a manual form only. It provides representative payees with information about representative payee liability and waiver.

NOTE: The representative payee's copy of the AONS notice incorporates this information.

2. Representative Payee Liability

The SSA-L8176-U2 informs the representative payee that we will ask him/her to repay the balance of the overpayment if the overpaid individual:

• Does not repay the overpayment; or

• Begins to repay the overpayment but stops before it is repaid.

3. Waiver Information

The SSA-L8176-U2 also informs the representative payee to contact the FO to request a waiver if:

• The SSI payments were used for the overpaid individual's needs; and

• It was not the representative payee's fault that the overpayment occurred.

B. WHEN TO USE

Issue an SSA-L8176-U2 with the representative payee's copy of the Notice of Overpayment when the overpaid individual has a representative payee.

C. PROCEDURE

Fill in the recipient's name on the first line of the notice and in the first line following the first caption, “Special Message for You as the Representative Payee.” Document the file with the FO copy of the notice.