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I-1-3-91. Exhibit—OIG, Allegation Management Division - Response Attachment

Last Update: 6/27/05 (Transmittal I-1-54)

Office of the Inspector General
Office of Investigations
Allegation Management Division

The attached allegation is referred for development and any corrective action necessary. At any time during the development stage, should potential fraudulent issues arise, please consult with the SSA/OIG Office of Investigations in your geographical area (see I-1-3-90 for guidance) citing the OIG AMD allegation number.

Please use the attached form to respond to OIG/AMD. You are responsible for responding to AMD regarding the disposition of this allegation. It is imperative that you specifically report any monetary overpayment/recovery realized as a result of this allegation report in your response.

OIG, ALLEGATION MANAGEMENT DIVISION - RESPONSE ATTACHMENT

From:

(Allegation No.):

PLEASE CHECK THE APPROPRIATE RESPONSE

  1. Allegation unsubstantiated [ ]

  2. Allegation substantiated/corrective action taken [ ]

  3. Allegation partially substantiated/corrective action taken [ ]

  4. No SSA violation [ ]

  5. Referred to OIG, Office of Investigations [ ]

Monetary Disposition

  1. Amount of overpayment:

  2. Amount of recovered funds:

  3. Other:

Prepared by:                                                              Date:

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