APPLICANT PENDING FEMA DECISION AND WAIVER NOTICE

Transcription

1 APPLICANT PENDING FEMA DECISION AND WAIVER NOTICE Dear : Yu are receiving this letter because yu currently have an appeal, a request fr cmprmise, r a request fr payment plan pending with the Federal Emergency Management Agency (FEMA), as a result f an imprper payment prvided t yu fr disaster assistance. Due t the FEMA Disaster Assistance Recupment Fairness Act f 2011 (DARFA), P.L , signed int law n December 23, 2011, yu might have the pprtunity t have yur debt frm the Federal Emergency Management Agency (FEMA) waived, if it was incurred frm a disaster that tk place between August 28, 2005 and December 31, This new law allws FEMA t waive sme debts, incurred during the abve dates, when the debt des nt invlve fraud; the presentatin f a false claim r misrepresentatin r debtr fault. The assistance must have been distributed because f FEMA errr; and cllectin wuld be against equity and gd cnscience, meaning that it wuld be unfair under the circumstances f yur case t cllect the debt. If the abve cnditins apply t yu, yu may nw request a waiver f yur debt. Please nte that yur waiver request is part f a new prcess required by a new law; it is entirely separate frm FEMA s rdinary appeals, cmprmise, and payment plan prcesses. We recmmend that yu read the fllwing infrmatin carefully. If yu have a pending appeal, yu shuld take this pprtunity t request a waiver and yur appeal will be cnsidered with yur waiver request. If yu previusly requested a payment plan r cmprmise, yu shuld take the pprtunity t request a waiver. Even if the waiver is denied, yur pending request fr a payment plan r cmprmise will be evaluated separately and yu will be ntified f the determinatin. Finally, nce yu ve submitted the waiver request and supprting dcumentatin, a member f ur team may cntact yu if additinal infrmatin is needed t prcess yur waiver request. What d yu need t d? If yu wuld like t be cnsidered fr a waiver f yur debt under this new law, yu must send FEMA a letter requesting a waiver that specifies why it wuld be unfair fr FEMA t cllect the debt. Again, the infrmatin required is different frm the infrmatin required fr an appeal, payment plan r cmprmise. Yur written request shuld prvide infrmatin that explains ne r mre f the fllwing: Cllecting the debt wuld cause yu serius financial hardship: Yur request shuld tell FEMA abut yur financial situatin and why yu cannt affrd t repay the mney. Yur letter shuld als prvide details abut any ther circumstances that create a hardship fr yu. Yu have spent the mney yu received frm FEMA fr disaster-related needs and yu have n ability t reclaim and return the funds t FEMA: Yur request shuld tell FEMA hw yu

2 spent the mney and why yu believe it was disaster-related. If yu have receipts fr the disaster-related expenses, prvide them t FEMA. Other persnal circumstances exist that wuld make cllectin burdensme r grssly unfair: This request may include infrmatin abut yur age, health, emplyment status, family r childcare bligatins, disability, r any ther circumstances yu believe FEMA shuld knw abut t infrm its decisin abut why it wuld be unfair t cllect this debt. This new law limits FEMA s authrity t waive debts fr husehlds that earn ver $90,000 per year. Therefre, husehlds earning ver $90,000 a year may nt receive a ttal waiver f their debt but may be eligible fr a partial waiver. When d yu need t request a waiver? Yu must send FEMA a letter requesting a waiver within 60 days f the date n this ntice. Please remember t include all the infrmatin yu have that supprts yur argument that it wuld be unfair fr FEMA t cllect yur debt. Yu are als required t fill ut the attached frm, prviding a certificatin t FEMA f yur husehld s Adjusted Grss Incme frm yur mst recent Federal tax return (2010 r 2011). Yur request shuld be mailed t: FEMA Individuals and Husehlds Prgram Natinal Prcessing Service Center P.O. Bx Hyattsville, MD Or Fax it t: Upn receipt f yur request fr a waiver, FEMA may need t cntact yu fr additinal infrmatin. If yu have an appeal pending with FEMA, FEMA will ntify yu f its decisin n the appeal at the same time it ntifies yu f its decisin n yur waiver request. If yu have a payment plan r cmprmise request pending with FEMA, FEMA will make a final determinatin n that request after a decisin is made n the waiver request. The final determinatin fr a payment plan r cmprmise will be mailed t yu in a separate letter after yu are ntified f the waiver determinatin. Interest Charges Because f the new law, FEMA is suspending the accrual f interest n yur debt fr the next 60 days r, if yu request a waiver, until a determinatin n the waiver request is made. Cnclusin If yu have questins abut this ntice, yu shuld immediately cntact FEMA s Recupment Helpline at between 9:00 AM and 8:00 PM EST, Mnday thrugh Friday. If yu have a speech

3 disability r hearing lss and use a TTY, call directly; if yu use 711 r Vide Relay Service (VRS), call Please nte that the decisin n yur appeal r yur request fr a cmprmise r a payment plan, r yur request fr a waiver will nly apply t assistance yu received frm FEMA's Individuals and Husehlds Prgram and has n bearing n any ther frm f federal assistance yu may have received r are currently receiving.

4 Debt Waiver Prcess In Summary FEMA is cmmitted t serving disaster survivrs as effectively as pssible, while als being respnsible stewards f taxpayer dllars. Our agency, alng with ther federal agencies, is required by law t bth identify federal dllars that may have been disbursed t individuals in errr and take steps t recver thse funds thrugh a debt cllectin prcess. This prcess is knwn as recupment. On December 23, 2011, the President signed the FEMA Disaster Assistance Recupment Fairness Act f 2011 (DARFA), P.L , which authrizes FEMA t waive sme debts. There are steps that survivrs must take in rder t apply fr a waiver. Wh is eligible fr a waiver? By law, a recupment case must meet all f the fllwing criteria t be eligible fr a full waiver: An imprper payment was received frm disasters declared between August 28, 2005, and December 31, 2010; The imprper payment did nt invlve fraud, presentatin f false claim, r misrepresentatin; The imprper payment was the result f an errr n the part f FEMA; The imprper payment was nt a result f fault n the part f the survivr; Cllectin f the debt wuld be against equity and gd cnscience which means that it wuld be unfair under the circumstances f the case t cllect the debt; and Fr a full waiver, the husehld s adjusted grss incme must be less than $90,000. What d yu need t d? Yu must respnd t the Ntice f Waiver yu receive in the mail within 60 days by sending FEMA a letter requesting a waiver that specifies why it wuld be unfair fr FEMA t cllect the debt. If yu have signed up fr E-Crrespndence, yu will receive an stating that yu have new crrespndence in the system. Yu will then have t lg int the system t see the Ntice f Waiver. Yur written request shuld prvide infrmatin that explains ne r mre f the fllwing: Cllecting the debt wuld cause yu serius financial hardship: Yur request shuld tell FEMA abut yur financial situatin and why yu cannt affrd t repay the mney. Yur letter shuld als prvide details abut any ther circumstances that create a hardship fr yu. Yu have spent the mney yu received frm FEMA fr disaster-related needs and yu have n ability t reclaim and return the funds t FEMA: Yur request shuld tell FEMA hw yu spent the mney and why yu believe it was disaster-related. If yu have receipts fr the disaster-related expenses, prvide them t FEMA. Other persnal circumstances exist that wuld make cllectin burdensme r grssly unfair: This request may include infrmatin abut yur age, health, emplyment status, family r childcare bligatins, any disability, r any ther circumstances yu believe FEMA shuld knw abut t assist us in determining why it wuld be unfair t cllect this debt. Yu will als be required t cmplete an Adjusted Grss Incme Affirmatin and Declaratin frm, prviding a certificatin t FEMA f yur husehld s Adjusted Grss Incme frm yur mst recent Federal tax return. Yu must send FEMA a letter requesting a waiver within 60 days f the date n the Ntice f Waiver. Please remember t include all relevant infrmatin and send yur request t: FEMA Individuals and Husehlds Prgram Natinal Prcessing Service Center P.O. Bx Hyattsville, MD Or Fax it t: What if yu have questins abut the Ntice f Waiver? If yu have questins, yu shuld immediately cntact FEMA s Recupment Helpline at between 9:00 AM and 8:00 PM EST, Mnday thrugh Friday. If yu have a speech disability r hearing lss and use a TTY, call directly; if yu use 711 r Vide Relay Service (VRS), call

5 DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY DEBT WAIVER ADJUSTED GROSS INCOME AFFIRMATION AND DECLARATION FEMA requests the fllwing infrmatin in rder t administratively prcess yur request fr a waiver f debt, as authrized by the Disaster Assistance Recupment Fairness Act f 2011: Adjusted Grss Incme (AGI) infrmatin must cme frm yur mst recent Federal tax return (2010 r 2011) as reprted n Line 37 f Internal Revenue Service (IRS) Frm 1040; Line 21 f Frm 1040A; r Line 4 f Frm 1040EZ. If Married Filing Separately, please add the AGI amunts frm the individual tax returns tgether t determine the ttal husehld AGI. If yu prefer, yu may send in a cpy f yur mst recently filed Federal incme tax returns instead f cmpleting the belw statement. WARNING Pursuant t Title 18 f the United States Cde: Whever knwingly and willfully falsifies, cnceals, r cvers up by any trick, scheme r device a material fact, r makes any materially false, fictitius r fraudulent statements r representatins, may be fined up t $250,000, imprisned, r bth (18 U.S.C. 287, 1001, and 3571). My ttal husehld Adjusted Grss Incme reprted n my mst recent Federal incme tax return (2010 r 2011) is $. My husehld des nt file a Federal incme tax return based upn the IRS requirements fr my husehld s filing status, age, and/r the type f incme received. My husehld incme was $ in By my signature, I certify and affirm, under penalty f perjury (28 U.S.C. 1746) that: All infrmatin I have prvided regarding my husehld s Adjusted Grss Incme is true and crrect t the best f my knwledge. In additin t yur certificatin belw, FEMA may later require yu t submit a cpy f yur Federal tax return. NAME (Print) SIGNATURE DATE DISASTER NUMBER REGISTRATION NUMBER PHONE NUMBER PRIVACY ACT STATEMENT DHS/FEMA will use this infrmatin t prcess yur waiver f debt pursuant t the Rbert T. Staffrd Disaster Relief and Emergency Assistance Act as amended, 42 U.S.C ; The Privacy Act f 1974, 5 U.S.C. 552a; The Federal Recrds Act, 44 U.S.C. 301; and the Disaster Assistance Recupment Fairness Act f 2011 (DARFA), Public Law (December 23, 2011). The infrmatin n this frm may be used by and disclsed t DHS persnnel, cntractrs, r thers wh need this infrmatin t assist in activities related t the principle purpses nted abve, per the Rutine Uses fund in the DHS/FEMA 008 Disaster Recvery Assistance Files System f Recrds Ntice, 74 Fed. Reg (September 24, 2009), DHS/ALL 008 DHS Accunts Receivable System f Recrds Ntice, 73 Fed.Reg (Octber 17, 2008), and DHS/ALL 013 DHS Claims System f Recrds, 73 Fed. Reg (Octber 28, 2008). The disclsure f this infrmatin is vluntary; hwever failure t prvide the infrmatin will prevent DHS/FEMA frm prviding a waiver. PAPERWORK BURDEN DISCLOSURE NOTICE The infrmatin yu prvided abve cnstitutes fllw-up cmmunicatins fr ICR Obtaining the infrmatin abve is authrized under 5 C.F.R (h) and 44 U.S.C. 3518(c)(1)(B)(ii). If yu have any questins r cncerns regarding the cllectin f the infrmatin abve, please cntact the FEMA helpline at , r fr individuals with hearing/speech impairment ONLY call (TTY).