SSI Overpayment Waiver Request
Request a waiver of SSI overpayment that was not your fault.
When to Use This Template
Use this when SSA says you were overpaid SSI benefits and wants repayment. If the overpayment was not your fault and repayment would deprive you of necessary living expenses, you may qualify for a waiver under the “without fault” and “against equity and good conscience” standards.
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[Your Full Name]
[Your Address]
[City, State ZIP]
[Date]
Social Security Administration
[Local SSA Field Office]
[Office Address]
[City, State ZIP]
Sent via Certified Mail, Return Receipt Requested
RE: Request for Waiver of SSI Overpayment, [Your Full Name], SSN ending [Last Four of SSN]
Dear Claims Representative:
I am writing to formally request a waiver of the Supplemental Security Income overpayment described in your notice dated [Date of Overpayment Notice], which states that I was overpaid [Overpayment Amount] for the period [Start Date] through [End Date]. Form SSA-632 (Request for Waiver of Overpayment Recovery) is enclosed, and I respectfully ask that recovery be suspended while this request is pending.
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Important Disclaimer
This template is provided for informational and educational purposes only and does not constitute legal, financial, medical, or professional advice. Every situation is unique. You should consult with a qualified attorney or licensed professional before sending any formal correspondence, especially for matters involving legal rights, government agencies, financial disputes, employment issues, or family court proceedings. Use of this template does not create an attorney-client or professional-client relationship. Formal Letter Templates is not a law firm and does not provide legal services.