Benefits you received to which you were not entitled are known as overpayments. Request a payoff letter using the online Claimant Lien Payoff Request Form.If you cannot complete the online form, call for assistance. You must include your name, your SSN, and your mailing address. An (OSIG-189) should not be filled out for vendor overpayments. (1) The Office of the Comptroller will issue a cost settlement letter to the provider notifying the provider of the amount of the overpayment. You must fill out one overpayment request form per employee per pay period.