LVY030 – LEVY AMOUNT DEDUCTED FROM PMA OR CMA
We withheld (1) from this payment to pay (2) debt to the IRS.
|
Fill-in values:
|
|
Fill-in (1)
|
|
|
Choice 1
|
Deductions Additions History Amount (DAH-AMOUNT) for the Deductions Additions History
Type of Payment (DAH-TOP) = P (PMA) with DAH-ITEM = 470
|
|
Choice 2
|
Show the DAH-AMOUNT for the DAH-TOP = R (RCMA) or C (PCMA) with DAH-ITEM = 470
|
|
Fill-in (2)
|
|
|
Choice 1
|
your
|
|
Choice 2
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)
|
LVY031 – LEVY AMOUNT DEDUCTED FROM MONTHLY BENEFIT PAYABLE (MBP)
We will withhold (1) from (2) payment each month to pay (3) debt to the IRS.
|
Fill-in values:
|
|
Fill-in (1)
|
Deductions Additions History Amount (DAH-AMOUNT) for the Deductions Additions History
Type of Payment (DAH-TOP) = M (MBP) with Deductions Additions History Item Code (DAH-ITEM)
= 470
|
|
|
|
|
Fill-in (2)
|
|
|
Choice 1
|
your
|
|
Choice 2
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)
|
|
Fill-in (3)
|
|
|
Choice 1
|
your
|
|
Choice 2
|
his
|
|
Choice 3
|
her
|
LVY032 – LEVY DEDUCTION STARTS AND LEDGER ACCOUNT FILE (LAF) = C AND CURRENT MONTHLY
ACCRUAL (CMA) = $0.00
We withheld (1) from (2) monthly payment to pay (3) debt to the IRS.
|
Fill-in values:
|
|
Fill-in (1)
|
Show the Deductions Additions History Amount (DAH-AMOUNT) for the Deductions Additions
History Type of Payment (DAH-TOP) = R (RCMA) or C (PCMA) with Deductions Additions
History Item Code (DAH-ITEM) = 470
|
|
|
|
|
|
|
|
Fill-in (2)
|
|
|
Choice 1
|
your
|
|
Choice 2
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)
|
|
Fill-in (3)
|
|
|
Choice 1
|
your
|
|
Choice 2
|
his
|
|
Choice 3
|
her
|
LVY033 – LEVY DEDUCTION AMOUNT CHANGES
We changed the amount we withhold from (1) monthly payment to pay (2) debt to the
IRS.
|
Fill-in values:
|
|
Fill-in (1)
|
|
|
Choice 1
|
your
|
|
Choice 2
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)
|
|
Fill-in (2)
|
|
|
Choice 1
|
your
|
|
Choice 2
|
his
|
|
Choice 3
|
her
|
LVY034 – LEVY AMOUNT NO LONGER DEDUCTED FROM SOCIAL SECURITY ADMINISTRATION BENEFITS
We are no longer withholding money from (1) payments to pay (2) debt to the IRS.
|
Fill-in values:
|
|
Fill-in (1)
|
|
|
Choice 1
|
your
|
|
Choice 2
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)
|
|
Fill-in (2)
|
|
|
Choice 1
|
your
|
|
Choice 2
|
his
|
|
Choice 3
|
her
|
LVY036 – LEVY REFUND AND ANOTHER TITLE II REDESIGN INTRODUCTORY PARAGRAPH IS GENERATED
This payment includes a refund of money we withheld to pay (1) debt to the IRS.
|
Fill-in values:
|
|
Fill-in (1)
|
|
|
Choice 1
|
your
|
|
Choice 2
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)
|
LVY037 – LEVY REFUND AND THERE IS NO OTHER TITLE II REDESIGN INTRODUCTORY PARAGRAPH GENERATED
(1) due a refund of money that we withheld to pay (2) debt to the IRS.
|
Fill-in values:
|
|
Fill-in (1)
|
|
|
Choice 1
|
You are
|
|
Choice 2
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) plus “is”
|
|
Fill-in (2)
|
|
|
Choice 1
|
your
|
|
Choice 2
|
his
|
|
Choice 3
|
her
|