Form SSA 632-BK Instructions

If you’ve received a notice of overpayment from the Social Security Administration, you may have also received instructions on how to reimburse the SSA for the Social Security overpayment.

According to the SSA website, you should also receive instructions on how to ask for:

  • Reconsideration of the overpayment, if you have good reason to believe you were not overpaid
  • Waiver of overpayment recovery, if you cannot, in good conscience, repay the overpayment because of your financial situation
  • A change in the repayment rate, if you feel you need to set up a repayment plan at a different rate.

If you are looking for a complete waiver of the overpayment amount, you’ll need to complete and submit Form SSA 632-BK, Request for Waiver of Overpayment Recovery for SSA consideration.

This in depth article will walk you through Form SSA-632-BK, step by step.

How do I complete Form SSA 632-BK?

In this section, we’ll walk through each part of this Social Security form, step by step. Let’s begin with Section 1.

Section 1: Identifying Questions

Section 1 ask questions to ascertain the identity of the person filing the waiver request. You’ll need to fill in:

  • Name
  • Social Security number
  • Relationship to the overpaid individual (if you are filling the form out on the overpaid person’s behalf).

If you are the overpaid person, you can skip to Section 4. If you are someone other than the overpaid person, you’ll need to complete Sections 2 & 3.

Section 1 identifies the person completing the SSA form

Section 2: Questions for Representative Payee

If you are a representative payee, you’ll need to complete Section 2. You’ll be expected to answer questions about:

  • Whether you were living with the overpaid person when they were overpaid, or if you are currently living with that person
  • Whether the overpaid person is a minor
  • Whether any of the money remains
  • How the overpayment was used
Form SSA-634-BK Section 2: If you are a representative payee, you'll complete Section 2.
Only complete Section 2 if you are a representative payee

Section 3: If You Are Responsible For A Family Member’s or Another Individual’s Overpayment

If the overpayment notice indicated that you are responsible for a family member’s overpayment, then you’ll complete Section 3. If not, go to Section 4.

Section 3 is completed by people responsible for a family member's overpayment or the overpayment of another individual

Section 4: Information About Receiving the Overpayment

Section 4 is arguably the longest part of Form SSA-632. You’ll be asked to answer questions about:

  • Your household situation when you received the overpayment
  • Whether you were receiving Social Security benefits
  • What type of benefits you were receiving
  • Why you are requesting the waiver
  • Whether you’re receiving other benefits, like VA disability benefits or Temporary Assistance for Needy Families (TANF), or public assistance
Form SSA-634-BK Section 4 goes into detail about the overpayment in question

Section 5: Financial Statement

In Section 5, you’ll provide financial information, in your financial statement, to support your case.

When you complete your financial statement, the SSA will expect you to provide supporting documentation as well. This documentation might include:

  • Proof of rent or mortgage
  • Recent utility bills
  • Pay statements or other proof of your income
  • Recent bank statements
Section 5: Financial Statement

Section 6: Members of Household

In section 6, you’ll list the name, age, and relationship of all the household members. If you’re an adult completing the waiver form, you’ll need to list your spouse and dependents in this section.

When completing this form on behalf of a minor, only provide the child’s name in Section 6, then the child’s information in Sections 7-9. If the child’s income and assets help offset the cost of food and household expenses, then you’ll complete these sections with the parents’ information as well.

Section 6: Members of Household

Section 7: Assets

In this field, you’ll state how much money you have, either in cash, banking accounts, or other assets. Additionally, you’ll be asked to list out other assets, like vehicles, real estate, business interests, or other important things such as valuables.

Form SSA-634-BK Section 7: Assets-things you have and own

Section 8: Monthly Household Income

In Section 8, you’ll fill in information about about your employment situation, as well as total income. In addition to your employment income, you’ll be asked to list all sources of income, such as:

  • Pension income
  • Public assistance programs, including monthly benefit amount
  • Social Security benefits
  • SSI payments
Section 8: Monthly household income

Section 9: Monthly Household Expenses

In Section 9, you’ll list out your monthly expenses. This includes monthly payments for:

  • Housing
  • Groceries
  • Medical expenses not covered by insurance
  • Other necessary living expenses, such as utilities, clothing, and work transportation

At the bottom of Section 9 is a remarks section for any explanatory comments.

Form SSA-634-BK Section 9: Monthly Household Expenses

Section 10: Income & Expenses Comparison

Section 10 is the income and expenses comparison. For monthly income, you’ll write in the grand total from line number 22 (Section 8). For monthly expenses, you’ll write the total from line number 23 (Section 9).

The SSA incorporates a $25 cushion for your expenses. From there, you’ll simply subtract the total monthly expenses from your monthly income.

Form SSA-634-BK Section 10: Income & Expenses Comparison

Section 11: Financial Expectation & Funds Availability

Do you expect to receive an inheritance? Is there any reason you cannot sell any of the financial assets you listed in your financial statement?

In Section 11, you’ll outline this information as part of the reporting requirements. If you have any detailed information that doesn’t fit into the specific line, you can continue in the remarks section.

Form SSA-634-BK Section 11: Financial Expectation & Funds Availability


To complete Form SSA-632-BK, you’ll need to sign this section to authorize your financial institutions to release pertinent information to the Social Security Administration. If you do not sign this release form, the SSA may not approve your waiver request.

Form SSA-634-BK Authorization for financial information

Penalty Clause, Certification, and Privacy Act Statement

As with other SSA forms, there is a penalty clause. Basically, you’re making the good faith representation, under penalty of perjury, that all financial and personal information you’re providing is true and accurate to the best of your knowledge. If you knowingly give a false statement, you may be subject to criminal charges.

Form SSA-634-BK Penalty clause

Video walkthrough

Watch this instructional video to learn more about requesting a waiver of Social Security overpayments using Form SSA-632-BK.

Frequently asked questions about Form SSA-632-BK

Here are some frequently asked questions about completing the Form SSA 632-BK.

Can SSA garnish my entire check for overpayments?

If you are receiving Social Security benefits, the SSA may garnish the entire check until your overpayment has been paid in full. For SSI payments, the SSA may withhold up to 10% of the maximum federal SSI benefits each month.

If I submit a request, will the SSA start taking my money anyway?

The SSA will not start withholding income from your benefits until 60 days after you’ve received your notice of overpayment. If you’ve submitted a waiver or have requested an appeal, the SSA will withhold collection efforts until a decision has been made.

Where can I find a copy of Form SSA-632-BK?

You may obtain a copy of the form at your local SSA office, through the SSA website, or by downloading the attached form below.

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