We are writing to [1] about the Internal Revenue Service (IRS) Notice of Levy.
What We Plan To Do
We asked [2] to tell us how many tax exemptions [3]. Based on the information [4]
gave us, IRS cannot take money out of [5][6].
If [7] more information or [8] any questions, please contact [9] local IRS office.
Fill-ins:
[1]
|
Choice 1 -
|
you
|
|
Choice 2 -
|
Name of beneficiary, in format: Mr. John Smith
|
[2]
|
Choice 1 -
|
you
|
|
Choice 2 -
|
him
|
|
Choice 3 -
|
her
|
[3]
|
Choice 1 -
|
you have
|
|
Choice 2 -
|
he has
|
|
Choice 3 -
|
she has
|
[4]
|
Choice 1 -
|
you
|
|
Choice 2 -
|
he
|
|
Choice 3 -
|
she
|
[5]
|
Choice 1 -
|
your
|
|
Choice 2 -
|
his
|
|
Choice 3 -
|
her
|
[6]
|
Choice 1 -
|
Social Security payments
|
|
Choice 2 -
|
Black Lung payments
|
|
Choice 3 -
|
Social Security and Black Lung payments
|
[7]
|
Choice 1 -
|
you need
|
|
Choice 2 -
|
he needs
|
|
Choice 3 -
|
she needs
|
[8]
|
Choice 1 -
|
have
|
|
Choice 2 -
|
has
|
[9]
|
Choice 1 -
|
your
|
|
Choice 2 -
|
his
|
|
Choice 3 -
|
her
|