Important Information About Your Appeal, Waiver Rights and Repayment Options

OMB 0960-0779

OMB 0960-0779

SSA uses Form SSA-3105, Important Information About Your Appeal, Waiver Rights, and Repayment Options, to explain these rights to overpaid individuals and allow them to notify SSA of their decision(s) regarding these rights. The respondents are overpaid claimants requesting a waiver of recovery for the overpayment; reconsideration of the fact of the overpayment; or a lesser rate of withholding of the overpayment.

The latest form for Important Information About Your Appeal, Waiver Rights and Repayment Options expires 2022-02-28 and can be found here.

OMB Details

Important Information About Your Appeal, Waiver Rights and Repayment Options - Debt Management System

Federal Enterprise Architecture: Income Security - General Retirement and Disability


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