BASIC (05-11)

NL 00720.205 LVY Tax Levy

LVY022 IRS TAX LEVY AMOUNT THAT WILL BE WITHHELD FROM A PMA (B02)

(System Generated)

Caption: What We Will Pay

We withheld  (1)  from  (2)  benefits due through  (3)  to pay  (4)  obligation to IRS.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: Money amount

Fill-in (2) - Systems Generated

Choice 1: Beneficiary's Name possessive

Choice 2: your

Fill-in (3) - Systems Generated

Choice 1: MM/CCYY in format "January 2006"

Fill-in (4) - Systems Generated

Choice 1: his

Choice 2: her

Choice 3: your

Choice 4: the

LVY023 IRS. ONGOING CHECK AMOUNT AFTER WITHHOLDING FROM THE PMA OR CMA (B03)

(System Generated)

Caption: What We Will Pay

Thereafter, we will withhold  (1)  from  (2)  benefit each month to pay  (3)  obligation to IRS.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: Money amount

Fill-in (2) - Systems Generated

Choice 1: Beneficiary's Name possessive

Choice 2: his

Choice 3: her

Choice 4: your

Fill-in (3) - Systems Generated

Choice 1: his

Choice 2: her

Choice 3: your

Choice 4: the

LVY024 TAX LEVY - NO CHANGE IN THE IRS TAX LEVY AMOUNT (A05)

(System Generated)

Caption: What We Will Pay

We will continue to withhold from  (1)  benefit each month to pay  (2)  obligation to IRS.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: Beneficiary's Name possessive

Choice 2: your

Fill-in (2) - Systems Generated

Choice 1: his

Choice 2: her

Choice 3: your

Choice 4: the

LVY025 TAX LEVY - WITHHOLDING DISCONTINUED (A06)

(System Generated)

Caption: What We Will Pay

We changed  (1)  payment to  (2)  beginning  (3)  because we are no longer withholding benefits to pay  (4)  obligation to IRS.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: Beneficiary's Name possessive

Choice 2: your

Fill-in (2) - Systems Generated

Choice 1: Money amount

Fill-in (3) - Systems Generated

Choice 1: MM/CCYY in format "January 2006"

Fill-in (4) - Systems Generated

Choice 1: his

Choice 2: her

Choice 3: your

Choice 4: the

LVY026 TAX LEVY AMOUNT INCREASING (A08)

(System Generated)

Caption: Your Benefits

We changed  (1)  payment to  (2)  beginning  (3)  because we are increasing the amount we are withholding each month to pay  (4)  obligation to IRS.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: Beneficiary's Name possessive

Choice 2: your

Fill-in (2) - Systems Generated

Choice 1: Money amount

Fill-in (3) - Systems Generated

Choice 1: MM/CCYY in format "January 2006"

Fill-in (4) - Systems Generated

Choice 1: his

Choice 2: her

Choice 3: your

Choice 4: the

LVY027 IRS TAX LEVY - AMOUNT BEING WITHHELD IS DECREASING (A25)

(System Generated)

Caption: What We Will Pay

We changed  (1)  payment to  (2)  beginning  (3)  because we are reducing the amount we are withholding each month to pay  (4)  obligation to IRS.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: Beneficiary's Name possessive

Choice 2: your

Fill-in (2) - Systems Generated

Choice 1: Money amount

Fill-in (3) - Systems Generated

Choice 1: MM/CCYY in format "January 2006"

Fill-in (4) - Systems Generated

Choice 1: his

Choice 2: her

Choice 3: your

Choice 4: the

LVY038 TAX LEVY AMOUNT WITHHELD FROM A CMA (B87)

(System Generated)

Caption: What We Will Pay

We withheld  (1)  from  (2)  next scheduled payment which is for  (3)  to pay  (4)  obligation to IRS.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: Money amount withheld from CMA payment

Fill-in (2) - Systems Generated

Choice 1: Beneficiary's Name possessive

Choice 2: your

Fill-in (3) - Systems Generated

Choice 1: MM/CCYY

Fill-in (4) - Systems Generated

Choice 1: his

Choice 2: her

Choice 3: your

LVY054 REFUND OF TAX — GENERAL PARAGRAPH FOR USE WHEN REFUND IS DUE FOR REASON OTHER THAN BENEFICIARY ESTABLISHING U.S. CITIZENSHIP OR RESIDENCY, OR RESIDENCY IN TAX TREATY COUNTRY — SSA CAN MAKE PARTIAL REFUND, IRS MUST REFUND BALANCE (A73)

(Requested)

Caption: Your Benefits

We deducted  (1)  in Federal income tax from  (2)  Social Security benefits in  (3) . Since we should have deducted  (4) ,  (5)  due a  (6)  refund. Part of this amount is for this year and part is for  (7) . We can only refund  (8) , which is the part for this year. We will send  (9)  a check for this amount soon. IRS should refund the rest of this money.

If IRS has not refunded the  (10)   (11)  due for  (12) ,  (13)  must request a refund from IRS in order to get this money. To request this refund,  (14)  must file a U.S. tax return and report  (15)  income. The return should be filed with the Internal Revenue Service Center, Philadelphia, PA 19255.

IRS has advised us that there is a time limit to request a refund. Generally,  (16)  must request a refund within 3 years after the due date of the tax return for the year we deducted the tax.

Fill-in values:

Fill-in (1) - Requested As A Money Amount In Format $$$$$$.¢¢

Choice 1: Amount of tax withheld in $$$$$.¢¢ format

Fill-in (2) - Systems Generated

Choice 1: your

Choice 2: Beneficiary's Name possessive

Fill-in (3) - Requested As A Date In Format MM/CCYY, OR MM/CCYY AND MM/CCYY, OR MM/CCYY THROUGH MM/CCYY

Choice 1: Month(s)/year(s) tax withheld in “MM/CCYY” or “MM/CCYY through MM/CCYY” format

Fill-in (4) - Requested As A Money Amount In Format $$$$$$.¢¢

Choice 1: Amount of tax SSA should have withheld in $$$$$.¢¢ format

Fill-in (5) - Systems Generated

Choice 1: you are

Choice 2: he is

Choice 3: she is

Fill-in (6) - Requested As A Money Amount In Format $$$$$$.¢¢

Choice 1: Amount of refund in $$$$$.¢¢ format

Fill-in (7) - Requested As A Date In Format MM/CCYY

Choice 1: Year in “MM/CCYY” format

Fill-in (8) - Systems Generated

Choice 1: Amount SSA can pay in $$$$$.¢¢ format

Fill-in (9) - Systems Generated

Choice 1: you

Choice 2: him

Choice 3: her

Fill-in (10) - Requested As A Money Amount In Format $$$$$$.¢¢

Choice 1: Amount IRS can pay in $$$$$.¢¢ format

Fill-in (11) - Systems Generated

Choice 1: you are

Choice 2: he is

Choice 3: she is

Fill-in (12) - Requested As A Year In Format CCYY

Choice 1: Year

Fill-in (13) - Systems Generated

Choice 1: you

Choice 2: he

Choice 3: she

Fill-in (14) - Systems Generated

Choice 1: you

Choice 2: he

Choice 3: she

Fill-in (15) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (16) - Systems Generated

Choice 1: you

Choice 2: he

Choice 3: she

LVY055 REFUND OF TAX FOR REASON OTHER THAN BENEFICIARY ESTABLISHING U.S. CITIZENSHIP OR RESIDENCY, OR RESIDENCY IN TAX TREATY COUNTRY — SSA CAN MAKE REFUND (A75)

(Requested)

Caption: Your Benefits

We deducted  (1)  in Federal income tax from  (2)  Social Security benefits in  (3) . We should have deducted  (4) . For this reason,  (5)  should receive a  (6)  refund. We will send  (7)  a check for this amount soon.

Fill-in values:

Fill-in (1) - Requested As A Money Amount In Format $$$$$$.¢¢

Choice 1: Amount of tax withheld in $$$$$.¢¢ format

Fill-in (2) - Systems Generated

Choice 1: your

Choice 2: Beneficiary's Name possessive

Fill-in (3) - Requested As A Date In Format MM/CCYY, OR MM/CCYY AND MM/CCYY,

OR MM/CCYY THROUGH MM/CCYY

Choice 1: Month(s) when tax was erroneously withheld in “MM/CCYY” or

“MM/CCYY through MM/CCYY” format

Fill-in (4) - Requested As A Money Amount In Format $$$$$$.¢¢

Choice 1: Amount we should have withheld in $$$$$.¢¢ format

Fill-in (5) - Systems Generated

Choice 1: you

Choice 2: he

Choice 3: she

Fill-in (6) - Requested As A Money Amount In Format $$$$$$.¢¢

Choice 1: Amount of refund in $$$$$.¢¢ format

Fill-in (7) - Systems Generated

Choice 1: you

Choice 2: him

Choice 3: her

LVY056 REFUND OF TAX FOR REASON OTHER THAN BENEFICIARY ESTABLISHING U.S. CITIZENSHIP OR RESIDENCY, OR RESIDENCY IN TAX TREATY COUNTRY — SSA CAN MAKE REFUND (A76)

(Requested)

Caption: Your Benefits

We deducted  (1)  in Federal income tax from  (2)  Social Security benefits in  (3) . Since  (4)  a  (5)   (6) , we should not have deducted any tax for this period.  (7)  due a  (8)  refund. Part of this refund is for this year and part is for  (9) . We can only refund  (10) , which is the part that is for this year. We will send  (11)  a check for this amount soon. IRS should refund the rest of this money.

If IRS has not refunded the  (12)   (13)  due for  (14) ,  (15)  must request a refund from IRS in order to get this money. To request this refund,  (16)  must file a U.S. tax return and report  (17)  income. The return should be filed with the Internal Revenue Center, Philadelphia, PA 19255.

IRS has advised us that there is a time limit to request a refund. Generally,  (18)  must request a refund within 3 years after the due date of the tax return for the year we deducted the tax.

Fill-in values:

Fill-in (1) - Requested As A Money Amount In Format Shown Below

Choice 1: Amount of tax withheld in $$$$$.¢¢ format

Fill-in (2) - Systems Generated

Choice 1: your

Choice 2: Beneficiary's Name possessive

Fill-in (3) - Requested As A Date In Format Shown Below

Choice 1: Month(s)/year(s) tax was erroneously withheld in MM/CCYY or MM/CCYY through MM/CCYY format

Fill-in (4) - Systems Generated

Choice 1: you were

Choice 2: he was

Choice 3: she was

Fill-in (5) - Requested As A One Position Alpha Character

Choice A: U.S. citizen

Choice B: resident of

Fill-in (6) - Requested As A One Position Alpha Character

Choice A: CANADA

Choice B: EGYPT

Choice C: GERMANY

Choice D: INDIA

Choice E: IRELAND

Choice F: ISRAEL

Choice G: ITALY

Choice H: JAPAN

Choice I: ROMANIA

Choice J: SWITZERLAND

Choice K: UNITED KINGDOM

Choice Z: NULL

Fill-in (7) - Systems Generated

Choice 1: You are

Choice 2: He is

Choice 3: She is

Fill-in (8) - Requested As A Money Amount In Format Shown Below

Choice 1: Amount of tax refund in $$$$$.¢¢ format

Fill-in (9) - Requested As A Date In Format Shown Below

Choice 1: Year in “MM/CCYY” format

Fill-in (10) - Requested As A Money Amount In Format Shown Below Choice 1: Amount SSA refunds in $$$$$.¢¢ format

Fill-in (11) - Systems Generated

Choice 1: you

Choice 2: him

Choice 3: her

Fill-in (12) - Requested As A Money Amount In Format Shown Below

Choice 1: Amount IRS should refund in $$$$$.¢¢ format

Fill-in (13) - Systems Generated

Choice 1: you are

Choice 2: he is

Choice 3: she is

Fill-in (14) - Requested As A Date In Format Shown Below

Choice 1: Year in “MM/CCYY” format

Fill-in (15) - Systems Generated

Choice 1: you

Choice 2: he

Choice 3: she

Fill-in (16) - Systems Generated

Choice 1: you

Choice 2: he

Choice 3: she

Fill-in (17) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (18) - Systems Generated

Choice 1: you

Choice 2: he

Choice 3: she


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900720205
NL 00720.205 - LVY Tax Levy - 05/20/2011
Batch run: 05/20/2011
Rev:05/20/2011