OMB control number
Request for Waiver of Overpayment Recovery or Change in Repayment Rate
OMB 0960-0037 · SSA.
An overpayment occurs when we pay a beneficiary or recipient more benefits than they are due for a given period. When the individual receives the overpaid benefits, they are responsible for repaying the debt. The information collected on the SSA-632 BK is mandatory for SSA to determine if we can waive an overpayment that is $1,000 or more. To determine if an overpaid individual has the ability to repay the overpayment, respondents are required to provide authorization for SSA to obtain their financial account information. A legal guardian must sign the financial authorization for an adult who is legally incompetent or if the overpaid individual is a child. In addition, respondents must provide household expenses, the income for the entire household, and the assets for all dependent household members. The respondent may complete this form alone or with help. The information collected on the SSA-634 is mandatory for SSA to approve a negotiated monthly rate of withholding that would not permit recovery of the overpayment within 36 months. SSA employees will collect this information one-time. An overpaid individual completes and submits this form along with proofs of their income, assets, and expenses. The individual may complete this form alone or with help. SSA is removing the signature requirement, consistent with Executive Order 14058. Respondents are overpaid individuals who are requesting a waiver of recovery of an overpayment, or a lesser rate of withholding.
The latest form for Request for Waiver of Overpayment Recovery or Change in Repayment Rate expires 2028-04-30 and can be found here.
Document Name |
|---|
Form |
Form |
Supporting Statement A |
SSA-632 - Request for Waiver of Overpayment Recovery
Federal Enterprise Architecture: Income Security - General Retirement and Disability
| Form SSA-632-BK | Request to Waiver of Overpayment Recovery | Fillable Printable | Form |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.