TN 31 (02-97)
Document Identifier for Word Processor: E3324
Although you never asked us to withhold any money from (1) Social Security benefits for voluntary Federal tax withholding, we withheld $ (2) . (3) We are sorry if our error caused you any inconvenience.
If You Have Any Questions
3901C
Fill-ins:
your; beneficiary's name, possessive in format
amount we withheld
Choice 1 - We are refunding this amount to you. (When the error is in the current year.)
Choice 2 - To receive the money we withheld, you must contact the Internal Revenue Service. (When the error is in the prior year.)
Choice 3 - We are refunding $ (a) to you that we withheld for the current year. To receive the $ (b) we withheld for the previous year, you must contact the Internal Revenue Service.
amount refunded
IRS amount
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.