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It is called Representative Payee Report of Benefits and Dedicated Account, SSA-6233-BK. You should keep these records (e.g. bank statements and canceled checks) along with receipts for two years from the time you complete the form.
Repaying the overpayment will put you into debt or make you unable to pay your ordinary living expenses. If you don't receive public assistance or SSI, you will have to list all of your necessary expenses/bills on the waiver form to show that you can't afford to pay Social Security back or.
An overpayment occurs when Social Security pays you more than you should have been paid. If this happens, we will notify you. Our notice will tell you why you have been overpaid and how you can pay us back.
Form SSA-632 | Request For Waiver Of Overpayment Recovery Or Change In Repayment Rate.
Getting a payment plan: Go to your local SSA Office and ask for a payment plan to pay back your overpayment. Offer a monthly payment amount that you are sure you can afford. Fill out an Income and Expense Statement to show that this amount is the most you can afford to pay each month.
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If you agree that you have been overpaid, but you feel you should not have to pay it back because you did not cause the overpayment and you cannot afford to repay it, you should file Form SSA-632, Request for Waiver of Overpayment Recovery.
Section 204(a) of the Social Security Act provides that the overpaid person (whether or not he or she still receives benefits), his or her representative payee, and any other person receiving benefits on the overpaid person's earnings record are liable (responsible) for repayment of an overpayment.
You can ask for a waiver at any time. You cannot pay back the overpayment because you need the money to meet your ordinary living expenses. You may have to submit proof of your income, as well as bills to show that all of your income is used for your monthly expenses and that it would be a hardship for you to repay.
Here are your choices: Ask for Reconsideration. This is an appeal. ... Ask for a Waiver. If you agree that you were overpaid, you can still ask SSA to waive it so that you don't have to pay it back. ... Ask for a Payment Arrangement. Do this if you think that the overpayment was your fault or you can afford to pay it back.
To complete a SSA-632-BK, you will need to provide the following information: Name. Social security number. Name of overpaid person making request and his or her social security number(s) Indicate if any of the following apply: ... Section I - Information About Receiving the Overpayment. ... Section II - Your Financial Statement.

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