case 2:15-cv-01732-pa-jc document 30-2 filed 06/17/15 page ... · case 2:15-cv-01732-pa-jc document...

Case 2:15-cv-01732-PA-JC Document 30-2 Filed 06/17/15 of 26 Page ID #:542

EXHIBIT A


EXHIBIT B


EXHIBIT C


Social Security AdministrationSupplemental Security IncomeOverpayment Information

SOCIAL SECURITYWILSHIRE CENTER4000 WILSHIRE BLVDLOS ANGELES, CA 90010-9918Date: April 30, 2015Claim Number:SI9

HUGH A. HELD

Dear HUGH HELD

We are writing to tell you that we are waiving the collection of yourSupplemental Security Income overpayment of $6205.30. This means you will nothave to pay this money back.

The Reason For Our Decision

For us to waive the collection of your overpayment, two things have to be true.

It was not your fault that you got too much Supplemental SecurityIncome.

AND

Paying us back would mean you cannot pay your bills for food, clothing,housing, medical care, or other necessary expenses, or it would be unfair forsome other reason.

Based on the facts we have, we found that both of these are true about you.Therefore, you will not have to pay us back.

See Next Page


of 3

If You Disagree With The Decision

If you disagree with the decision, you have the right to appeal. We will reviewyour case again and consider any new facts you have. A person who did not makethe first decision will decide your case.

You have 60 days to ask for an appeal.

The 60 days start the day after you get this letter. We assume you got thisletter 5 days after the date on it unless you show us that you did not get itwithin the 5-day period.

You must have a good reason if you wait more than 60 days to ask for anappeal.

You have to ask for an appeal in writing. We will ask you to sign a formSSA-561-U2, called "Request for Reconsideration." Contact one of ouroffices if you want help.

How to Appeal:

There are two ways to appeal. You can pick the one you want. If you meet withus in person, it may help us decide your case.

Case Review . You have the right to review the facts in your file.You can give us more facts to add to your file. Then we will decide yourcase again. You will not meet with the person who decides your case.

Informal Conference . You will meet with the person who decides yourcase. You can tell that person why you think you are right. You can give usmore facts to help prove you are right. You can bring other people to helpexplain your case.

If You Want Help With Your Appeal

You can have a friend, representative or someone else help you. There aregroups that can help you find a representative or give you free legal services ifyou qualify. There also are representatives who do not charge unless you win yourappeal. Your local Social Security office has a list of groups that can help youwith your appeal.

If you get someone to help you, you should let us know. If you hire someone, wemust approve the fee before he or she can collect it. And if you hire arepresentative who is eligible for direct pay, we will withhold up to 25 percent


of 3

of any past due benefits to pay toward the fee.

Suspect Social Security Fraud?

Please visit http://oig.ssa.gov/r or call the Inspector General's FraudHotline at 1-800-269-0271 (TTY 1-866-501-2101).

If You Have Questions

We invite you to visit our website at www.socialsecurity.gov on the Internet tofind general information about Social Security. If you have any specificquestions, you may call us toll-free at 1-800-772-1213, or call your local SocialSecurity office at 877-803-6308. We can answer most questions over the phone. Ifyou are deaf or hard of hearing, you may call our TTY number, 1-800-325-0778.You can also write or visit any Social Security office. The office that servesyour area is located at:

SOCIAL SECURITY6TH FLOOR SUITE 650611 W 6TH STREETLOS ANGELES, CA 90017-3106

If you do call or visit an office, please have this letter with you. It willhelp us answer your questions. Also, if you plan to visit an office, you may callahead to make an appointment. This will help us serve you more quickly when youarrive at the office.


EXHIBIT D


EXHIBIT E


Social Security AdministrationSupplemental Security IncomeOverpayment Information

SOCIAL SECURITY354 MAIN ST STE 2GARDNER, MA 01440-3841Date: April 30, 2015Claim Number:RT1

KENA RICHARDSON-WRI FORKELLEY RICHARDSON-WRIGH

Dear KENA RICHARDSON-WRI

We are writing to tell you that we are waiving the collection of yourSupplemental Security Income overpayment of $4,129.88. This means you will nothave to pay this money back.

The Reason For Our Decision

For us to waive the collection of your overpayment, two things have to be true.

It was not your fault that you got too much Supplemental SecurityIncome.

AND

Paying us back would mean you cannot pay your bills for food, clothing ,housing, medical care, or other necessary expenses, or it would be unfair forsome other reason.

Based on the facts we have, we found that both of these are true about you.Therefore, you will not have to pay us back.

See Next Page


of 3

If You Disagree With The Decision

If you disagree with the decision, you have the right to appeal. We will reviewyour case again and consider any new facts you have. A person who did not makethe first decision will decide your case.

You have 60 days to ask for an appeal.

The 60 days start the day after you get this letter. We assume you got thisletter 5 days after the date on it unless you show us that you did not get itwithin the 5-day period.

You must have a good reason if you wait more than 60 days to ask for anappeal.

You have to ask for an appeal in writing. We will ask you to sign a formSSA-561-U2, called "Request for Reconsideration." Contact one of ouroffices if you want help.

How To AppealThere are two ways to appeal. You can pick the one you want. If you meet withus in person, it may help us decide your case.

Case Review . You have the right to review the facts in your file.You can give us more facts to add to your file. Then we will decide yourcase again. You will not meet with the person who decides your case.

Informal Conference . You will meet with the person who decides your case.You can tell that person why you think you are right. You can give us morefacts to help prove you are right. You can bring other people to helpexplain your case.

If You Want Help With Your Appeal

You can have a friend, representative or someone else help you. There aregroups that can help you find a representative or give you free legal services ifyou qualify. There also are representatives who do not charge unless you win yourappeal. Your local Social Security office has a list of groups that can help youwith your appeal.If you get someone to help you, you should let us know. If you hire someone, wemust approve the fee before he or she can collect it. And if you hire arepresentative who is eligible for direct pay, we will withhold up to 25 percentof any past due benefits to pay toward the fee.


of 3

Suspect Social Security Fraud?

Please visit http://oig.ssa.gov/r or call the Inspector General's FraudHotline at 1-800-269-0271 (TTY 1-866-501-2101).

If You Have Questions

We invite you to visit our website at www.socialsecurity.gov on the Internet tofind general information about Social Security. If you have any specificquestions, you may call us toll-free at 1-800-772-1213, or call your local SocialSecurity office at 877-628-6580. We can answer most questions over the phone. Ifyou are deaf or hard of hearing, you may call our TTY number, 1-800-325-0778.You can also write or visit any Social Security office. The office that servesyour area is located at:

SOCIAL SECURITY354 MAIN ST STE 2GARDNER, MA 01440-3841

If you do call or visit an office, please have this letter with you. It willhelp us answer your questions. Also, if you plan to visit an office, you may callahead to make an appointment. This will help us serve you more quickly when youarrive at the office.


case 2:15-cv-01732-pa-jc document 30-2 filed 06/17/15 page ... · case 2:15-cv-01732-pa-jc document...

Documents