Basic (05-06)
LVY001
NOTE: This UTI will only be generated on the notice
to IRS
Caption
None
English
We are writing to you about the Notice of Levy for IRS Control Number (1).
Spanish
Estamos escribiéndole sobre el Aviso de Recaudación de Impuestos para el Número de
Control del Servicio de Impuestos Internos (IRS, por sus siglas en inglés) (1).
Fill-In:
(1) 9 Position numeric IRS Control Number
LVY002
Caption
None
English
You asked us to take money out of the Social Security payments for (1). We are not
withholding the amount requested in the Notice of Levy because (2) (3).
Spanish
Usted nos pidió que saquemos dinero de los pagos de Seguro Social de (1). No estamos
reteniendo la cantidad solicitada en el Aviso de Recaudación de impuestos porque (2)
(3).
FILL-INS
(1) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
(2) Choice 1
Choice 2
(3) Choice 1
English
|
does not currently receive any payments
|
Spanish
|
actualmente no recibe ningún pago
|
Choice 2
English
|
has a benefit amount that is lower than the lowest exemption allowed
|
Spanish
|
tiene una cantidad de beneficios que es menos de la exención mínima permitida
|
LVY003
Caption
Use under caption REFC01 “If You Have Any Questions”
English
If you have any questions, please write to us at the above address.
Spanish
Si tiene alguna pregunta, por favor escríbanos a la dirección mencionada previamente.
LVY004
Caption
None
English
You asked us to take money out of the Social Security payments for (1).
Spanish
Usted nos pidió que saquemos dinero de los pagos de Seguro Social de (1).
Fill-in
(1) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
LVY006
Caption
None
English
We will no longer take money out of (1) monthly Social Security payments because;
-
•
you recently sent us a release from levy, or
-
•
this individual is no longer receiving payments, or
-
•
this individual’s benefit amount is less than the total exemption amount
The (2) that we sent you in (3) is the last payment you will receive.
Spanish
No continuaremos deduciendo dinero de los pagos mensuales de Seguro Social de (1),
porque;
-
•
recientemente ustedes nos enviaron una orden de
cesión de impuestos, o
-
•
esta persona ya no recibe pagos, o
-
•
la cantidad de los beneficios de esta persona es
menos que el total de la cantidad exenta.
Los (2) que le enviamos el (3) es el último pago que recibirá.
FILL-INS
(1) Choice 1
English
|
BGN plus BLN possessive
|
Spanish
|
BGN plus BLN
|
(2) Amount of last tax levy withholding
(3) MM/CCYY LEVY-TERM-DATE
Levy Notice System
LVY007
Caption
None
English
The Internal Revenue Service (IRS) has asked us to take money from (1) Social Security
payments because (2) them money.
Spanish
El Servicio de Impuestos Internos (IRS, por sus siglas en inglés) nos ha pedido que
saquemos dinero de los pagos de Seguro Social de (1) porque (2) les debe dinero.
FILL-INS
(1) Choice 1
English
|
BGN plus BLN possessive
|
Spanish
|
BGN plus BLN
|
Choice 2
English
|
your
|
Spanish
|
usted
|
(2) Choice 1
English
|
he owes
|
Spanish
|
él
|
Choice 2
English
|
she owes
|
Spanish
|
ella
|
Choice 3
English
|
you owe
|
Spanish
|
usted
|
LVY008
This UTI will always require the use of LVY017
Caption Use under caption INFC03 “What You Need To Do”
English
To help decide the correct amount of money to send the IRS,
(1) (2) to complete page 2 of this letter “Statement of Exemptions and Filing Status”
and return it within 10 days from the date you receive this letter. Return the completed
statement in the enclosed envelope. Please keep a copy for your records.
If we do not receive the completed statement within the 10 day period, IRS will only
allow an exemption amount of $(3).
Spanish
Para ayudar a decidir la cantidad correcta de dinero para enviar al IRS, (1) (2) necesita
completar la página 2 de esta carta “Declaración de Exenciones y Estado de Solicitud”
y devolverla dentro de 10 días de la fecha en que usted reciba esta carta. Devuelva
la declaración completada en el sobre adjunto. Por favor mantenga una copia para sus
archivos.
Si no recibimos la declaración completada dentro del plazo de 10 días, el IRS solamente
permitirá una cantidad de exención de $ (3).
FILL-INS
(1) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
Choice 2
English
|
you
|
Spanish
|
usted
|
(2) Choice 1
English
|
needs
|
Spanish
|
null
|
Choice 2
English
|
need
|
Spanish
|
(null)
|
(3) Amount of IRS exemption for Married Filing Separately in $$$$.cc format from data
element MRRDS-EX1-AMT in table
IRSEXMPN.
LVY009
Caption
Use under caption REFC01 “If You Have Any Questions”
English
If you need more information or have any questions, please contact your local IRS
office
Spanish
Si necesita más información o si tiene alguna pregunta, por favor comuníquese con
su oficina local de IRS.
LVY010
Caption
None
English
We are writing to you about the Internal Revenue Service (IRS) Notice of Levy.
Spanish
Estamos escribiéndole sobre el Aviso de Recaudación de Impuestos del Servicio de Impuestos
Internos (IRS, por sus siglas en inglés).
LVY012
Caption
Use under caption LVYC01 “What We Will Take Out”
English
The Internal Revenue Service (IRS) will take all of (1) Social Security payment beginning
with the payment (2) would receive around (3) because (4) them money. The IRS calls
this action a Notice of Levy.
Spanish
El Servicio de Impuestos Internos (IRS, por sus siglas en inglés) cogerá todo el pago
de Seguro Social (1) comenzando con el pago que (2) recibiría alrededor de (3) porque
(4) les debe dinero. El IRS llama a esta acción un Aviso de Recaudación.
FILL-INS
(1) Choice 1
English
|
BGN plus BLN possessive
|
Spanish
|
de BGN plus BLN
|
Choice 2
English
|
your
|
Spanish
|
suyo
|
(2) Choice 1
Choice 2
Choice 3
English
|
you
|
Spanish
|
usted
|
(3) Date of first check being withheld from GUCHKDTE
(4) Choice 1
English
|
he owes
|
Spanish
|
él
|
Choice 2
English
|
she owes
|
Spanish
|
ella
|
Choice 3
English
|
you owe
|
Spanish
|
usted
|
LVY013
Caption
None
English
You asked us not to let the Internal Revenue Service (IRS) take money out of (1) Social
Security payments.
When the IRS tells us to take money out of monthly payments to collect unpaid taxes,
we must do so. The IRS makes the decision on whether SSA will take part or all of
(2) payment.
Spanish
Usted nos pidió que no permitamos que el Servicio de Impuestos Internos (IRS, por
sus siglas en inglés) saque dinero de los pagos de Seguro Social de (1).
Cuando el IRS nos avisa que saquemos dinero de los pagos mensuales para cobrar impuestos
pendientes, lo tenemos que hacer. El IRS toma la decisión sobre si la Administración
del Seguro Social sacará una porción o todo su (2) pago.
FILL-INS
(1) Choice 1
English
|
BGN plus BLN possessive
|
Spanish
|
|
Choice 2
English
|
your
|
Spanish
|
usted
|
(2) Choice 1
Choice 2
Choice 3
English
|
your
|
Spanish
|
null
|
LVY014
Caption
Use under caption LEVC01 “What We Will Take Out”
English
The Internal Revenue Service (IRS) will take part of (1) Social Security benefits
because (2) them money. The IRS calls this action a Notice of Levy.
Spanish
El Servicio de Impuestos Internos (IRS, por sus siglas en inglés) tomará una porción
de los beneficios de Seguro Social (1) porque (2) les debe dinero. El IRS llama esta
acción un Aviso de Recaudación de Impuestos.
FILL-INS
(1) Choice 1
English
|
BGN plus BLN possessive
|
Spanish
|
de BGN plus BLN
|
Choice 2
English
|
your
|
Spanish
|
suyos
|
(2) Choice 1
English
|
he owes
|
Spanish
|
él
|
Choice 2
English
|
she owes
|
Spanish
|
ella
|
Choice 3
English
|
you owe
|
Spanish
|
usted
|
LVY016
Caption
None
English
The Internal Revenue Service (IRS) will no longer take money out of (1) monthly payment
because (2) no longer (3) Social Security payments.
Spanish
El Servicio de Impuestos Internos (IRS, por sus siglas en inglés) ya no sacará dinero
del pago mensual (1) porque (2) ya no recibe (3) pagos de Seguro Social.
FILL-INS
(1) Choice 1
English
|
BGN plus BLN (possessive)
|
Spanish
|
De BGN plus BLN
|
Choice 2
English
|
your
|
Spanish
|
suyo
|
(2) Choice 1
Choice 2
Choice 3
English
|
you
|
Spanish
|
usted
|
(3) Choice 1
English
|
receive
|
Spanish
|
null
|
Choice 2
English
|
receives
|
Spanish
|
null
|
LVY017
Caption
None
English
STATEMENT OF EXEMPTIONS AND FILING STATUS
(TO BE COMPLETED BY TAXPAYER)
My filing status for my Income Tax Return is (check one):
____Single ____Married Filling a Joint Return
____Head of Household ____Qualifying Widow(er)
____Married Filling a Separate Return
I also claim additional exemption(s) for:
____Age 65 ____Blind
I certify that I can claim the people named below as personal exemptions on my income
tax return and that none are claimed on another Notice of Levy. No one I have listed
is my minor child to whom (as required by court or administrative order) I make support
payments that are already exempt from levy. I understand the information I have provided
may be verified by the Internal Revenue Service. Under penalties of perjury, I declare
that this statement of exemptions and filing status is true.
Name of dependents claimed as exemptions:
Name Relationship Social Security Number
__________________ ______________ _____________________
__________________ ______________ _____________________
__________________ ______________ _____________________
__________________ ______________ ______________________
__________________ _______________ ______________________
__________________ _______________ ______________________
__________________ ________________
Taxpayer’s Signature Date
SPANISH This UTI will be in English only
LVY018
Caption
None
English
The Internal Revenue Service (IRS) will no longer take money out of (1) monthly payment
because (2) no longer (3) IRS any money.
Spanish
El Servicio de Impuestos Internos (IRS, siglas en inglés) ya no deducirá dinero del
pago mensual de (1) porque (2) ya no (3) le debe dinero al IRS.
FILL-INS
(1) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
Choice 2
English
|
your
|
Spanish
|
null
|
(2) Choice 1
Choice 2
Choice 3
English
|
you
|
Spanish
|
usted
|
(3) Choice 1
Choice 2
English
|
owes
|
Spanish
|
null
|
LVY040
Caption None
English
We are increasing (1) Social Security payments beginning (2). Therefore, we will also
increase the amount we take from each monthly payment to collect what (3) owes IRS.
Spanish
Estamos aumentando los pagos de Seguro Social de (1) comenzando en (2). Por lo tanto,
también aumentaremos la cantidad que deducimos de cada pago mensual para cobrar lo
que (3) le debe al IRS.
FILL-INS
(1) Choice 1
English
|
BGN plus BLN possessive
|
Spanish
|
BGN plus BLN
|
(2) MM/CCYY
(3) Choice 1
Choice 2
LVY041
Caption
Used under caption “What We Plan To Do”
English
We are reducing (1) Social Security payments beginning (2). Therefore, we will also
reduce the amount we take from each monthly payment to collect what (3) owes IRS.
Spanish
Estaremos reduciendo los pagos de Seguro Social de (1) comenzando en (2). Por lo tanto,
también reduciremos la cantidad que deducimos de cada pago mensual para cobrar lo
que (3) le debe al IRS.
FILL-INS
(1) Choice 1
English
|
BGN plus BLN possessive
|
Spanish
|
BGN plus BLN
|
(2) MM/CCYY
(3)Choice 1
Choice 2
LVY042
English
We are increasing (1) Social Security payments beginning (2). Therefore, we will also
increase the amount we take from each monthly payment to collect what (3) (4) IRS.
Spanish
Estamos aumentando la cantidad de los pagos de Seguro Social de (1) comenzando en
(2). Por lo tanto, también aumentaremos la cantidad que deducimos de cada pago mensual
para cobrar lo que (3) (4) le debe al IRS.
FILL-INS
(1) Choice 1
English
|
BGN plus BLN possessive
|
Spanish
|
BGN plus BLN
|
Choice 2
English
|
your
|
Spanish
|
usted
|
(2) MM/CCYY
(3) Choice 1
Choice 2
Choice 3
English
|
you
|
Spanish
|
usted
|
(4) Choice 1
English
|
owes
|
Spanish
|
null
|
Choice 2
LVY043
Caption
Used under caption “What We Will Take Out”
English
We are reducing (1) Social Security payments beginning (2). Therefore, we will also
increase the amount we take from each monthly payment to collect what (3) (4) IRS.
Spanish
Estamos reduciendo la cantidad de pagos de Seguro Social de (1) comenzando en (2).
Por lo tanto, también reduciremos la cantidad de dinero que deducimos de cada pago
mensual para cobrar lo que (3) (4) debe al IRS.
FILL-INS
(1) Choice 1
English
|
BGN plus BLN possessive
|
Spanish
|
BGN plus BLN
|
Choice 2
English
|
your
|
Spanish
|
usted
|
(2) MM/CCYY
(3) Choice 1
Choice 2
Choice 3
English
|
you
|
Spanish
|
usted
|
(4) Choice 1
English
|
owes
|
Spanish
|
Null
|
Choice 2
LVY044
Caption – “What We Plan To Do”
English
IRS asked us to take (1) from any retroactive payments (2) (2) (3) due to pay IRS.
We withheld (4) from the payment (5) will receive around (6). You will receive another
letter showing the payment amount (7) will receive.
Spanish
El IRS nos pidió que dedujéramos (1) de cualquier pago retroactivo que se le debe
a (2) (3) para pagarle al IRS. Retuvimos (4) del pago que (5) recibirá alrededor de
(6). Usted recibirá otra carta declarando la cantidad que (7) recibirá.
FILL-INS
(1) Amount
(2)Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
Choice 2
English
|
you
|
Spanish
|
usted
|
(3) Choice 1
Choice 2
(4) Amount of withholding from the PMA for Tax Levy
(5) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
Choice 2
English
|
you
|
Spanish
|
usted
|
(6) MM/DD/CCYY that payment will be received (business day plus 7 days)
(7) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
Choice 2
English
|
you
|
Spanish
|
usted
|
LVY 045
English
You asked us to take (1) from any retroactive payments (2) is due to pay IRS. We withheld
(3) from the payment (4) will receive around (5).
Spanish
Usted nos pidió que dedujéramos (1) del cualquier pago retroactivo que se le deba
a (2) para pagar al IRS. Retuvimos (3) del pago que (4) recibirá alrededor de (5).
FILL-INS
(1) Amount
(2) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
(3) Amount of withholding from the PMA for Tax Levy
(4) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
(5) MM/DD/CCYY that payment will be received (business day plus 7 days)
LVY046
Caption – “What We Plan To Do”
English
You asked us to take (1) from each monthly payment (2) is due to pay IRS. We withheld
(3) from the payment (4) will receive around (5
Spanish
Usted nos pidió que dedujéramos (1) de cada pago mensual que se le debe a (2) para
pagarle al IRS. Retuvimos (3) del pago que (4) recibirá alrededor de (5).
FILL-INS
(1) Amount of Tax Levy withheld from the CMA payment
(2) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
(3) Amount of withholding for Tax Levy from CMA
(4) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
(5)
MM/DD/CCYY that CMA payment will be received
LVY047
English
IRS asked us to take (1) from each monthly payment (2) (3) due to pay IRS. We withheld
(4) from the payment (5) will receive around (6). You will receive another letter
showing the payment (7) will receive.
Spanish
El IRS nos pidió que dedujéramos (1) de cada pago mensual que se le debe a (2) (3)
para pagarle al IRS. Retuvimos (4) del pago que (5) recibirá alrededor de (6). Usted
recibirá otra carta declarando el pago que (7) recibirá.
FILL-INS
(1) Amount of Tax Levy withheld from the CMA payment
(2) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
Choice 2
English
|
you
|
Spanish
|
usted
|
(3) Choice 1
Choice 2
(4) Amount of withholding for Tax Levy from CMA
(5) Choice 1
Choice 2
Choice 3
English
|
you
|
Spanish
|
usted
|
(6) MM/DD/CCYY that CMA payment will be received
(7) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
Choice 2
English
|
you
|
Spanish
|
usted
|
LVY048
Caption – “What We Plan To Do”
English
IRS asked us to take (1) from each monthly payment (2) (3) due to pay IRS. We will
withhold (4) beginning (5). You will receive another letter showing the payment amount
(6) will receive.
Spanish
El IRS nos pidió que dedujéramos (1) de cada pago mensual que se le debe a (2)(3)
para pagar al IRS. Retendremos (4) comenzando en (5). Usted recibirá otra carta indicando
el pago que (6) recibirá.
FILL-IN
(1)Amount of Tax Levy withheld from ongoing MBP
(2)Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
Choice 2
English
|
you
|
Spanish
|
usted
|
(3) Choice 1
Choice 2
(4) Amount of withholding for Tax Levy from ongoing MBP
(5) MM/CCYY that ongoing monthly withholding amount was changed
(6)Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
Choice 2
English
|
you
|
Spanish
|
usted
|
LVY049
Caption – “What We Plan To Do”
English
You asked us to take (1) from each monthly payment (2) is due to pay IRS. We will
withhold (3) beginning (4).
Spanish
Usted nos pidió que dedujéramos (1) de cada pago mensual que se le debe a (2) para
pagarle al IRS. Retendremos (3) comenzando en (4).
FILL-INS
(1)Amount of Tax Levy withheld from ongoing MBP
(2) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
(3) Amount of withholding for garnishment from ongoing MBP
(4) MM/CCYY that ongoing monthly withholding amount was changed
LVY050
PMA and CMA being paid and ongoing MBP changing
English
You asked us to take (1) from any retroactive payments (2) is due to pay IRS. You
also asked us to take (3) from each monthly payment. We withheld (4) from the payment
(5) will receive around (6) and (7) from the payment (8) will receive around (9) and
(10) from the monthly payments beginning (11).
Spanish
Usted nos pidió que dedujéramos (1) de cualquier pago retroactivo que se le deba a
(2) para pagarle al IRS. Usted también nos pidió que dedujéramos (3) de cada pago
mensual. Retuvimos (4) del pago que (5) recibirá alrededor de (6) y (7) del pago que
(8) recibirá alrededor de (9) y (10) de los pagos mensuales comenzando en (11).
FILL-INS
(1) Amount of Tax Levy being withheld from the PMA payment
(2) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
(3)Amount of Tax Levy withholding from MBP payment
(4) Amount of Tax Levy withholding from PMA payment
(5)Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
(6) MM/DD/CCYY that PMA payment will be received (business day plus 7 days)
(7) Amount of garnishment withholding from CMA payment
(8)Choice 1
Choice 2
(9)MM/DD/YYYY that CMA payment will be made
(10) Amount of Tax Levy withholding from ongoing MBP
(11) MM/YYYY that ongoing MBP will reflect Tax Levy withholding
LVY051
English
IRS asked us to take (1) from any retroactive payments (2) (3) due to pay IRS. IRS
also asked us to take (4) from each monthly payment. We withheld (5) from the payment
(6) will receive around (7) and (8) from the payment (9) will receive around (10)
and (11) from the monthly payments beginning (12). You will receive another letter
showing the payment amounts (13) will receive.
Spanish
El IRS nos pidió que dedujéramos (1) de cualquier pago retroactivo que se le deba
a (2) (3) para pagarle al IRS. El IRS también nos pidió que dedujéramos (4) de cada
pago mensual. Retuvimos (5) del pago que (6) recibirá alrededor de (7) y (8) del pago
que (9) recibirá alrededor de (10) y (11) de los pagos mensuales comenzando en (12).
Usted recibirá otra carta indicando la cantidad que (13) recibirá.
FILL-INS
(1) Amount of Tax Levy being withheld from the PMA payment
(2) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
Choice 2
English
|
you
|
Spanish
|
usted
|
(3) Choice 1
Choice 2
(4) Amount of Tax Levy being withheld from the MBP payment
(5) Amount of Tax Levy being withheld from PMA
(6) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
Choice 2
English
|
you
|
Spanish
|
usted
|
(7) MM/DD/CCYY that PMA payment will be received (business day plus 7 days)
(8) Amount of Tax Levy withholding from CMA
(9) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
Choice 2
English
|
you
|
Spanish
|
usted
|
(10) MM/DD/YYYY that CMA payment will be received
(11) Amount of Tax Levy withholding from ongoing MBP
(12) MM/YYYY that ongoing withholding amount will begin
(13) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
Choice 2
English
|
you
|
Spanish
|
usted
|
LVY052
CMA being paid and ongoing MBP changing. No PMA being
paid
English
IRS asked us to take (1) from each monthly payment (2) (3) due to pay IRS. We withheld
(4) from the payment (5) will receive around (6). After that we will withhold (7)
each month. You will receive another letter showing the payment amount (8) will receive.
Spanish
El IRS nos pidió que dedujéramos (1) de cada pago mensual que se le deba a (2) (3)
para pagarle al IRS. Retuvimos (4) del pago que (5) recibirá alrededor de (6). Después,
retendremos (7) cada mes. Usted recibirá otra carta indicando la cantidad del pago
que (8) recibirá.
FILL-INS
(1) Show the amount in data element MBP_WHLDG_AMT in table CANCTRL
(2) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
Choice 2
English
|
you
|
Spanish
|
usted
|
(3) Choice 1
Choice 2
(4) Amount of Tax Levy withholding from CMA payment
(5) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
Choice 2
English
|
you
|
Spanish
|
usted
|
(6) MM/DD/YYYY that CMA payment will be paid
(7) Amount of Tax Levy withholding from ongoing MBP
(8) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
Choice 2
English
|
you
|
Spanish
|
usted
|
LVY053
CMA being paid and ongoing MBP changing. No PMA being
paid
Caption – “What We Plan To Do”
English
You asked us to take (1) from each monthly payment (2) is due to pay IRS. We withheld
(3) from the payment (4) will receive around (5). After that we will withhold (6)
each month.
Spanish
Usted nos pidió que dedujéramos (1) de cada pago mensual de (2) que usted recibe para
pagarle al IRS. Retuvimos (3) del pago que (4) recibirá alrededor del (5). Continuaremos
reteniendo (6) cada mes.
FILL-INS
(1) Amount of Tax Levy being withheld from the MBP
(2)Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
(3) Amount of Tax Levy withholding from CMA
(4) Choice 1
English
|
BGN plus BLN
|
Spanish
|
BGN plus BLN
|
(5) MM/DD/YYYY that CMA payment will be received
(6) Amount of Tax Levy withholding from ongoing MBP