TN 33 (02-98)

NL 00703.753 Notification to Beneficiary -Levy Ceasing

Document Identifier: E3753

Exhibit Letter

We are writing to tell [1] that the Internal Revenue Service (IRS) will no longer take money out of [2] monthly payment because [3][4]. [5] receive [6] regular monthly payment of $[7] around [8].

If [9] more information or [10] any questions, please contact [11] local IRS office.

Fill-ins:

[1]

Choice 1 -

you

 

Choice 2 -

Name of beneficiary, in format: Mr. Smith

[2]

Choice 1 -

your

 

Choice 2 -

his

 

Choice 3 -

her

[3]

Choice 1 -

you no longer receive

 

Choice 2 -

he no longer receives

 

Choice 3 -

she no longer receives

 

Choice 4 -

null

[4]

Choice 1 -

Social Security payments

 

Choice 4 -

IRS sent us a Release From Levy

[5]

Choice 1 -

You will

 

Choice 2 -

He will

 

Choice 3 -

She will

[6]

Choice 1 -

your

 

Choice 2 -

his

 

Choice 3 -

her

[7]

$$ amount of benefit

[8]

MM/DD/YYYY benefit is expected

[9]

Choice 1 -

you need

 

Choice 2 -

he needs

 

Choice 3 -

she needs

[10]

Choice 1 -

have

 

Choice 2 -

has

[11]

Choice 1 -

your

 

Choice 2 -

his

 

Choice 3 -

her


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900703753