TAX002 COA — DOMESTIC TO FOREIGN (A81)

(Requested)

Caption: What We Will Pay

We will withhold Federal income tax from  (1)  benefit each month starting (2)  . If  (3)  is a citizen or U.S. resident, please let us know and we will stop withholding the tax.

The United States has income tax treaties with Canada, Egypt, Germany, India, Ireland, Israel, Italy, Japan, Romania, Switzerland and the United Kingdom that may reduce or eliminate this tax on Social Security benefits for certain residents of these countries. Please contact the Internal Revenue Service to learn more about these treaties. Please contact us to stop or reduce the tax if  (4)  the conditions of an income tax treaty.

TAX003 ALIEN WITHHOLDING TAX APPEAL (A86)

(System Generated)

Caption: Your Benefits

We use information about  (1)  citizenship and residency to decide whether to withhold Federal income tax from  (2)  benefits. If you think we have the wrong information, please contact us. We collect this tax for the Internal Revenue Service (IRS). If you have questions about this tax, or to learn about  (3)  appeal rights, please contact the IRS.

TAX004 REFUND OF TAX — GENERAL PARAGRAPH FOR USE WHEN REFUND IS DUE— SSA CANNOT MAKE REFUND (A74)

(Requested)

Caption: Your Benefits

We deducted too much in Federal income tax from your Social Security benefits in  (1)  . Since we deducted too much, you are due a  (2)  refund. Because this refund is not for this year, we cannot pay you this money. IRS should refund this money.

If IRS has not refunded the  (3)  you are due for  (4)  , you must request a refund from IRS in order to get this money. To request this refund, you must file a U.S. tax return and report your 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, you must request a refund within 3 years after the due date of the tax return for the year we deducted the tax.

TAX006 ALIEN TAX DEDUCTION CONTINUES (G25)

(System Generated)

Caption: Your Benefits

We will continue to deduct Federal income tax from your monthly checks.

TAX011 COA — NONTAX TREATY TO TAX TREATY COUNTRY (A83)

(Requested)

Caption: Your Benefits

Because of the information you gave us, we are no longer deducting Federal income tax from your monthly benefits. This is because of a treaty which says we will not tax Social Security benefits paid to residents of  (1)  .

Please let us know if you change your address again.

TAX019 REFUND OF TAX — BENEFICIARY ESTABLISHED U.S. CITIZENSHIP OR RESIDENCY, OR RESIDENCY IN A TAX TREATY COUNTRY — SSA CANNOT MAKE REFUND (A77)

(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)  should receive a  (8)  refund. Because the refund is not for this year, we cannot pay  (9)  this money. IRS should refund 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.

TAX020 REFUND OF TAX — BENEFICIARY ESTABLISHED U.S. CITIZENSHIP OR RESIDENCY, OR RESIDENCY IN A TAX TREATY COUNTRY — SSA CAN MAKE REFUND (A78)

(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)  should receive a  (8)  refund. We will send  (9)  a check for this amount.

TAX021 COA — TAX TREATY TO NONTAX TREATY COUNTRY (A82)

(Requested)

Caption: Your Benefits

We are deducting a Federal income tax from  (1)  your benefits each month. We did not deduct the tax before  (2)  because you were living in  (3)  . We will stop deducting the tax or deduct it at a lower rate if:

 (4)  a U.S. citizen,

OR

 (5)  in the United States, Canada, Egypt, Germany, Ireland, Israel, Italy, Japan, Romania, Switzerland or the United Kingdom.

 (6) 

Please let us know if any of these things happen.

TAX022 CHANGE IN TAX STATUS — NEW INFORMATION OR EVIDENCE SUBMITTED (A84)

(Requested)

Caption: Your Benefits

Because of the information  (1)  gave us, we are  (2)  deducting Federal income tax from  (3)  benefits. We do not deduct this tax or deduct it at a lower rate if  (4)  a U.S. citizen, or if  (5)  in the United States, Canada, Egypt, Japan, Romania, Ireland, Israel, Italy, Germany, Switzerland or the United Kingdom.  (6)  Please let us know if  (7)   (8)  address again.

TAX023 ALIEN WITHHOLDING INCREASED TO 25.5 PERCENT (A85)

(Requested)

Caption: Your Benefits

We are deducting a Federal income tax of 25.5 percent from  (1)  Social Security benefit each month. This is because of a change in the United States Internal Revenue law which says that we must tax Social Security benefits at this higher rate.

TAX024 REFERRAL TO IRS FOR QUESTIONS ABOUT TAX LIABILITY (A87)

(Requested)

Caption: Your Benefits

If  (1)  any further questions about  (2)  tax, please write to the Internal Revenue Service, Taxpayer Service Division, Washington, DC 20225.

TAX025 NO CHANGE IN TAX STATUS — NEW INFORMATION OR EVIDENCE SUBMITTED (A89)

(Requested)

Caption: Your Benefits

We will continue to deduct a Federal income tax from  (1)  benefit each month. The new facts  (2)  gave us did not cause us to stop deducting the tax. We will stop deducting the tax or deduct it at a lower rate if:

• •

   (3)  a U.S. citizen,

OR

• •

   (4)  in the United States, Canada, Egypt, Germany, Ireland, Israel, Italy, Japan, Romania, Switzerland or the United Kingdom.

 (5)  Please let us know if any of these things happen

TAX026 OVERPAYMENT INCLUDES AMOUNTS WITHHELD FOR NONRESIDENT ALIEN TAX - OVERPAID PERSON IN NONPAY STATUS - NO CROSS PROGRAM ADJUSTMENT (A91)

(Requested)

Caption: Your Benefits

 (1)  total overpayment is  (2)  . This includes the Federal income tax we deducted from the benefits  (3)  not due.

When  (4)  us back,  (5)   (6)  . We will use the tax we deducted from  (7)  check to get back the rest of the overpayment.

TAX027 WITHHOLDING TAX (DOE 12/83 OR LATER) (G27)

(System Generated)

Caption: Your Benefits

We are deducting Federal income tax from  (1)  benefit each month  (2)   (3)  . We will stop deducting the tax or deduct it at a lower rate if:

• •

   (4)   (5)  a U.S. citizen, or

• •

   (6)   (7)  in the United States, Canada, Egypt, Germany, Ireland, Israel, Italy, Japan, Romania, Switzerland or the United Kingdom

Also, if an individual is a citizen and resident of India, all or part of that person's benefits can be exempt from this Federal income tax if those benefits are based on Federal, State or local government employment.

 Please contact us if any of these things happen.

We collect this tax for the Internal Revenue Service. So, if you disagree with the decision to tax  (8)  , you will have to contact them to appeal. However, if you think we made a mistake about where  (9)   (10)  or about  (11)  citizenship, let us know. We will correct the mistake.

TAX050 COA — FOREIGN TO DOMESTIC — BENEFICIARY SUBJECT TO ALIEN TAX UNTIL RESIDENCE IN U.S. ESTABLISHED (A80)

(Requested)

Caption: Your Benefits

We are deducting Federal income tax from  (1)  benefits because our records show that  (2)  . We may stop deducting the tax if  (3)  of the U.S. Please get in touch with a Social Security office if  (4)  .