[Date]
[Debtor name]
[Address]
[City, State ZIP]
Re: Amount of past due debt owed to the U.S. Fish and Wildlife Service: [enter amount]
Date of Bill: [enter date]
Bill Number(s): [enter bill number(s)]
[enter name of debtor:]
You have not paid the amount you owe the U.S. Fish and Wildlife Service (Service) for the above listed bill(s); see attached billing document(s) for more detailed information. If you do not pay your debt or take other action as described below before [enter date debt will be remanded], the Service will submit your debt to Treasury Cross-Servicing for collection. We will continue to add interest, penalties, and other charges to your unpaid debt until paid in full.
CROSS-SERVICING: Once your debt is submitted to Cross-Servicing, the U.S. Department of the Treasury (U.S. Treasury) can reduce or withhold any of your eligible Federal and State payments by the amount of your debt. The Debt Collection Act of 1982 and the Debt Collection Improvement Act of 1996 authorizes this process, which is known as “offset.” You may not receive another notice before your payment is offset. Federal and State payments eligible for offset include:
- your income tax refunds (see Attachment A for additional information);
- your Federal and State salary, including military pay (see Attachment A for additional information);
- your Federal and State retirement, including military retirement pay;
- your contractor/vendor payments;
- certain Federal benefit payments, such as Social Security (other than Supplemental Security Income (SSI)), Railroad Retirement (other than tier 2), and Black Lung (part B) benefits; and
- other Federal payments, including certain loans to you, that are not exempt from offset.
Before we submit your debt to Cross-Servicing, we are required to inform you that you may: (1) inspect and copy our records related to the debt; (2) request a review of our determination that you owe this debt; and (3) enter into an acceptable written repayment agreement. See Attachment A for additional information.
TO AVOID CROSS-SERVICING, you must take one of the following actions by [enter date debt will be remanded]:
- REPAY YOUR DEBT:
-Pay your debt online at Pay.gov or
-Send a check or money order payable to the U.S. Fish and Wildlife Service for the full amount that you owe to:
U.S. Fish and Wildlife Service
JAO Collections
P.O. Box 272065
Denver, CO 80227-9060
BANKRUPTCY: If you filed for bankruptcy and the automatic bankruptcy stay is in effect, you are not subject to offset while the stay is in effect. Please notify us of the stay by sending evidence concerning the bankruptcy.
If you make or provide any knowingly false or frivolous statement, representations, or evidence, you may be liable for penalties under the False Claims Act (31 U.S.C. 3729 - 3731) or other applicable statute, and/or criminal penalties under 18 U.S.C. Part II, or other applicable statutes.
Unless prohibited by law or contract, we will promptly refund to you any amounts paid by you or deducted from your payment for your debt which are later waived or found not owed to the United States.
If you have any questions about this letter or your rights, please email: fws_finance_collections_help@fws.gov.
Sincerely,
[enter accountant’s name]
Accountant, JAO Collections
Attachments
Attachment A
IF YOU FILE A JOINT INCOME TAX RETURN: If you file a joint income tax return, you should contact the Internal Revenue Service before filing your return. Request information regarding the steps to take to protect the share of any income tax refund which may be payable to your spouse, who is not a delinquent debtor to the U.S. Government.
IF YOU ARE OR BECOME A FEDERAL EMPLOYEE:
Your current net disposable pay is subject to offset if you do not pay your debt or take other action described above. Under Cross-Servicing, the U.S. Treasury can deduct up to 15% of your disposable net pay beginning in the pay period that your debt is submitted to Cross-Servicing and continuing every pay period until your debt, including interest, penalties, and other costs, is paid in full.
You are entitled to a hearing to dispute the existence or amount of the debt, or the amount of the payroll deduction. To request a hearing, you must file a written request for a hearing no later than [enter date debt will be remanded]. The timely filing of a petition for hearing will stay the commencement of salary offset proceedings. A final decision on the hearing will be issued no later than 60 days after the filing of a petition requesting the hearing (unless extended by the hearing official). Written requests for a hearing must be sent to:
U.S. Fish and Wildlife Service
JAO Collections
P.O. Box 272060
Denver, CO 80227
If you make or provide any knowingly false or frivolous statements, representations, or evidence, in addition to other penalties, you may be subject to disciplinary actions.
If you become a Federal employee after receipt of this letter, you should email fws_finance_collections_help@fws.gov.