807 A2 Sample Terminated Employee Overpayment Letter

Date

Dear [Employee Name]:

Our office received notification that your employment ended with the agency on [Date]. Due to an administrative error, you remained in pay status and received three full paychecks on [Pay Period Ending Date], [Pay Period Ending Date], and [Pay Period Ending Date]. These funds were directly deposited into your checking account as follows:

The overpayment amount $_____________ has been offset with _______ hours of unused accrued annual leave, a dollar value of ___________. A cashier’s check or money order payable to Georgia Department of Human Services for the difference, $_____________, must be received in our office no later than _______________. If you are unable to submit this amount, please contact me within thirty-days (30) calendars from the date of this letter, to make other arrangements for refunding the department. In order to receive an accurate W-2 for ______, the repayment must be completed by _______________.

Feel free to contact me at ____________________ if you have any questions. Your cooperation in this matter is greatly appreciated. However, if we do not hear from you by ___________________, this matter will be turned over to the DHS Office of General Counsel.

Sincerely,