TN 31 (02-97)
Document Identifier for Word Processor: E3323
Since the amount due (1) (2) (3) is not enough for voluntary Federal tax withholding, we cannot honor your request.
If You Have Any Questions
Use this notice when withholding is requested but the MBP is less than the amount
calculated for VTW. Use alone or with paragraph VTW001.
you; beneficiary's name
Choice 1 - through (when PMA or CMA)
Choice 2 - for (when CMA only)
Choice 3 - from (when MBP or CMA and MBP)
Choice 4 - null
Date in format May 1996 or null
Refer to NL 00703.005E for 3901C text and fill-ins.
Use Form SSA-L2000-C2 (Universal Notice) and follow the notice standards. Because
the requested fill-ins and paragraphs may vary according to different situations,
follow the requester's instructions carefully.