We are writing to tell [1] that the Internal Revenue Service (IRS) will take [2] [3]
of $[4] beginning with the payment [5] would receive around [6] because [7] them money.
The IRS calls this action a Notice of Levy.
If [8] more information or [9] any questions, please contact [10] local IRS office.
Fill-ins:
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[1]
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Choice 1 -
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you
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Choice 2 -
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Name of beneficiary, in format: Mr. John Smith
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[2]
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Choice 1 -
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your
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Choice 2 -
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his
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Choice 3 -
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her
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[3]
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Choice 1 -
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Social Security payments
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Choice 2 -
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Black Lung payments
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Choice 3 -
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Social Security and Black Lung payments
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[4]
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$$ amount of monthly benefit
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[5]
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Choice 1 -
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you
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Choice 2 -
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he
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Choice 3 -
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she
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[6]
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MM/DD/YYYY
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[7]
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Choice 1 -
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you owe
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Choice 2 -
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he owes
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Choice 3 -
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she owes
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[8]
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Choice 1 -
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you need
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Choice 2 -
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he needs
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Choice 3 -
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she needs
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[9]
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Choice 1 -
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have
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Choice 2 -
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has
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[10]
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Choice 1 -
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your
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Choice 2 -
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his
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Choice 3 -
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her
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