SSA-632 - Request for Waiver of Overpayment Recovery

1. Requestor’s Information

2. Representative Payee Information
2.1. Still Has Overpaid Money

2

2.2. Does Not Have Overpaid Money

3

3. Responsible for another Person’s Overpayment

4

4. Information about the Overpayment
4.1. Main Page

5

4.2. Modals
4.2.1. Requestor’s Overpayment Reason(s)

6

4.2.2. Overpaid Person’s Situation

7

4.2.3. Requestor’s Reason for Waiver

8

5. Information about the Overpayment - Part 2
5.1. Main Page

9

5.2. Modal

10

6. Income Based on Need
6.1. Main Page

11

6.2. Modal

12

7. Financial Statement

13

8. Members of the Household
8.1. Non-Dependent in Household

14

8.2. Lives with Household Members

15

9. Cash

16

10. Financial Account Information
10.1. Main Page

17

10.2. Modal

18

11. Vehicles
11.1. Main Page

11.2. Modal

19

12. Real Estate
12.1. Main Page

12.2. Modal

20

13. Business, Property, or Valuables
13.1. Main Page

13.2. Modal

21

14. Wages and Self Employment
14.1. Main Page

14.2. Modal
14.2.1. Self-Employment

22

14.2.2. Employed

23

15. Social Security Benefits

24

16. Pension
16.1. Main Page

16.2. Modal

25

17. SNAP

26

18. Child Support or Alimony

27

19. Other Income

28

20. Monthly Household Expenses

29

21. Income and Expenses Comparison

30

22. Financial Expectation and Funds Availability

31

23. AFI Authorization

32

24. Waiver Attestation

33

25. Summary

34

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