Social Security Hardship Form
Hardship letter social security.
Social security hardship form. Complete every field on this form. Basic 08 09 rm 10205 425 exception to ssn card limits due to hardship. When to complete this form.
Form ssa 632 bk 04 2019 uf discontinue prior editions social security administration. They may not be able to obtain their needed medication go to hospital for treatment or meet the expenses for their critical care. Form ssa 632bk request for waiver of overpayment recovery an overpayment occurs when social security pays you more than you should have been paid.
Page 1 of 14 omb no. When a number holder nh reaches his or her yearly or lifetime ssn card limits an ssn replacement card may still be issued if failure to receive an ssn card will cause a hardship. You think that you are not at fault for the overpayment and you cannot afford to pay the money back.
Necessary documentation for both your discharge request and your request for hardship review. Noamt of op 1. Complete this form if you are requesting that we adjust the current rate of withholding to recover your overpayment because you are unable to meet your necessary living expenses.
Request for waiver of overpayment recovery. I understand that the process is long and difficult for many people but i believe that i may qualify for critical need. Enclosed with this notice is a statement of financial status form.
A hardship letter to social security is also known as a dire need letter. Request for change in overpayment recovery rate. Disability claimants in particular are commonly affected by financial hardship.
If this happens we will notify you. Page 1 of 8 omb no. Form ssa 634 09 2019 discontinue prior editions social security administration.
If you believe that offset of your social security benefits will cause financial hardship. Only certain situations are classed as dire need so it is very important that you consider those. Check any of the following that apply.
I am writing this letter to request that my social security disability claim be processed as a dire need case. If you download print and complete a paper form please mail or take it to your local social security office or the office that requested it from you. Our notice will tell you why you have been overpaid and how you can pay us back.
Request for waiver of overpayment recovery or change in repayment rate. If you can t find the form you need or you need help completing a form please call us at 1 800 772 1213 tty 1 800 325 0778 or contact your local social security office and we will help you. Complete this form if any of the following applies.
If an answer is zero write zero. Page 1 of 9 omb no. For ssa use only.
If the individual does not allege undue hardship a determination is not required but document the file si 01150 126e.