OMB control number

Request for Waiver of Overpayment Recovery or Change in Repayment Rate

OMB 0960-0037 · SSA.

OMB 0960-0037

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.

All Historical Document Collections
Extension without change of a currently approved collection 2025-03-11
Approved without change
No material or nonsubstantive change to a currently approved collection 2023-11-22
Approved with change
Revision of a currently approved collection 2021-10-29
Approved without change
No material or nonsubstantive change to a currently approved collection 2020-09-16
Approved without change
No material or nonsubstantive change to a currently approved collection 2019-05-16
Approved without change
Revision of a currently approved collection 2018-08-29
Approved without change
Revision of a currently approved collection 2017-07-03
Approved without change
Revision of a currently approved collection 2014-06-02
Approved without change
Revision of a currently approved collection 2011-03-31
Approved without change
Revision of a currently approved collection 2009-02-26
Approved without change
Extension without change of a currently approved collection 2007-07-03
Approved with change
Extension without change of a currently approved collection 2004-06-10
Approved without change
Extension without change of a currently approved collection 2001-04-20
Approved without change
Reinstatement without change of a previously approved collection 2000-07-28
Approved without change
Extension without change of a currently approved collection 1999-11-01
Approved without change
Extension without change of a currently approved collection 1996-08-16
Approved without change
Extension without change of a currently approved collection 1993-07-30
Approved without change
Revision of a currently approved collection 1990-06-18
Approved without change
Extension without change of a currently approved collection 1988-04-20
Approved without change
Extension without change of a currently approved collection 1987-08-27
Approved without change
Revision of a currently approved collection 1986-08-19
Approved without change
Extension without change of a currently approved collection 1986-03-05
Approved without change
Extension without change of a currently approved collection 1984-12-21
Approved without change
Extension without change of a currently approved collection 1981-12-21
Approved with change
No material or nonsubstantive change to a currently approved collection 1979-03-28
Approved without change
Revision of a currently approved collection 1977-01-25
Approved without change
Extension without change of a currently approved collection 1975-10-23
OMB Details

SSA-632 - Request for Waiver of Overpayment Recovery

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Form SSA-632-BKRequest to Waiver of Overpayment RecoveryFillable PrintableForm

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.