Sample Letter Explained Form (Page 2 of 3) in pdf

SAMPLE LETTER

To:

Department of the Treasury

Office of D.C. Pensions

Attn: Employee Relations Team

U.S. Department of the Treasury

Washington, D.C. 20220

Re:

Request for Reconsideration and Waiver of Debt

I am a retired member of the District of Columbia Fire and Emergency Medical Services ("DCFEMS").

I was appointed to the DCFEMS on September 1, 1970. I retired on February 28, 1992. I am 67 years old; my

date of birth is March 1, 1948. My pension is my sole source of income.

On January 27, 2015, I received a letter from ODCP informing me that the Government had over paid my

pension and that ODCP was taking action to collect $8,000 in alleged overpayments. A copy of the letter I received

is enclosed herewith. Also enclosed is the completed Request for Reconsideration of Benefit Determination Cover

Sheet sent to me with the collection letter. I hereby request reconsideration of the ODCP decision and a waiver of

the collection action. I also request that I be provided with all documentation which is the basis for the collection

action.

Basis for reconsideration and waiver request:

(1)

The alleged overpayment did not involve fraud, misrepresentation or lack of good faith on my

part; the overpayment was entirely due to a mistake(s) by the Government.

(2)

I am not at fault in causing or contributing to the alleged overpayment. I did not provide any

fraudulent or incorrect information, nor was I aware of any mistake in my pension payments. I completed all

the information required to retire from DCFEMS and I trusted the Government to make the correct

calculation of my retirement benefits. If I had known that my pension payments were incorrect, I would have

notified DCFEMS or the D.C. Retirement Board. I do not manage the retirement system, the Government does.

The alleged error was not obvious and is not one I would have easily detected.

(3)

Collecting this alleged debt from me would be against equity and good conscience. A

collection action against me would cause me a severe personal and financial hardship.

(4)

I am 67 years old. I have no other source of income. I have the following health conditions

and limitations, Cancer, Diabetes and Severe Arthritis. I need substantially all of my pension payments to meet my

current financial obligations and my current and anticipated ordinary and necessary living expenses, which include

rent/mortgage payments of $1,800 per month, utilities of $450 per month, home maintenance of $250 per month,

transportation costs of $175 per month, food costs of $400 per month, clothing costs of $50 per month, life

insurance costs of $65 per month, health insurance costs of $775 per month, accident insurance of $25 per month. I

do not have any substantial liquid assets or other income from which I could pay this alleged debt

Name

Address

February 4, 2015

Sample Letter Explained Form Page 2