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

3901C

Fill-ins:

Use this notice when withholding is requested but the MBP is less than the amount calculated for VTW. Use alone or with paragraph VTW001.

1. (1) 

   you; beneficiary's name

2. (2) 

   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

3. (3) 

   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.