The form addresses overpayment for SSI in Pennsylvania, specifically for individuals who may have overpaid their benefits. It includes a payment voucher and instructions for returning funds to the appropriate state department. The form highlights key features such as tracking the reimbursement process and ensuring correct submission of funds. Users must provide accurate information including their personal details and the amount being refunded. Filling instructions are straightforward, encouraging clear labeling of the payment details to avoid delays. The form serves a variety of target audiences including attorneys, partners, owners, associates, paralegals, and legal assistants who may assist clients in managing their SSI accounts. It is particularly useful for those representing individuals facing financial adjustments to their SSI benefits or addressing overpayment issues efficiently. Understanding how to utilize this form can help legal professionals ensure compliance with state regulations while providing effective support to their clients.