Overpayment Notification Sample Letter
Sample Letter 8
Overpayment Notification Sample Letter
Memorandum
To:
From:
Date:
Subject: Notification of Overpayment of Wages
This memorandum serves as notification of an overpayment of wages that you received and the subsequent repayment that is your responsibility. The overpayment totals $ for pay period (EXAMPLE: 3/1-15/99 THROUGH 5/16-31/99).
You were overpaid in error because .
Please contact me at to discuss your method of repayment by . Failure to respond timely will result in the immediate recovery of the overpayment.
If you disagree with the amount listed below, you have the right to an immediate Pre-decision Meeting with a person who has direct access to the agency appointing authority for this purpose.
A summary of the overpayment is as follows:
| |Total | | | |Total Net Pay |
| |Gross |W/H |FICA |Other | |
| | | | | | |
|Received | | | | | |
| | | | | | |
|Due | | | | | |
| | | | | | |
|Overpayment | | | | | |
| | |
|Add Employee portion of insurance premium | |
| | |
|Add Deferred Compensation State Match | |
|If prior year(s) overpayment, then add total W/H Overpayment and year 4 and prior of FICA | |
| | |
|Repayment Amount | |
cc: Office of the Comptroller of the Treasury Division of State Audit
Technical Services Division of the Department of Personnel
F & A Payroll
................
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