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.

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.

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.

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.

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.

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.

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.

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.

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.

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.