NL 00720: Manual Adjustment, Credit and Award Process (MADCAP) Beneficiary Notice Print Program
TN 2 (09-11)
VTW001 General Information About Voluntary Tax Withholding (VTW) (V01)
(Requested/Generated)
Caption: Your Benefits
You asked that we withhold money from (1) benefits for voluntary Federal tax withholding. You want (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) .
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: your
Choice 2: Beneficiary's Name possessive
Fill-in (2) - Requested As A One or Two Position Number
Choice 1: a number between 5 and 40 representing the percentage of withholding
Fill-in (3) - Requested As A One Position Alpha Character
Choice 1: (A) withheld
Choice 2: (B) null
Fill-in (4) - Requested As A One Position Alpha Character
Choice 1: (A) beginning
Choice 2: (B) for
Choice 3: (C) null
Fill-in (5) -Requested As A Date In Format Shown Below or As A One Position Alpha Character
Choice 1: Date MM/CCYY
Choice 2: (B) null
Fill-in (6) - Requested As A One Position Alpha Character
Choice 1: (A) and
Choice 2: (B) through
Choice 3: (C) null
Fill-in (7) - Requested As A Date In Format Shown Below or As A One Position Alpha Character
Choice 1: Date MM/CCYY
Choice 2: (B) null
Fill-in (8) - Requested As A One Position Alpha Character
Choice 1: (A) ,
Choice 2: (B) and
Choice 3: (C) null
Fill-in (9) - Requested As A One or Two Position Number
Choice 1: a number between 5 and 40 representing the percentage of withholding
Choice 2: (B) null
Fill-in (10) - Requested As A One Position Alpha Character
Choice 1: (A) withheld
Choice 2: (B) null
Fill-in (11) - Requested As A One Position Alpha Character
Choice 1: (A) beginning
Choice 2: (B) for
Choice 3: (C) null
Fill-in (12) - Requested As A Date In Format Shown Below or As A One Position Alpha Character
Choice 1: Date MM/CCYY
Choice 2: (B) null
Fill-in (13) - Requested As A One Position Alpha Character
Choice 1: (A) and
Choice 2: (B) through
Choice 3: (C) null
Fill-in (14) - Requested As A Date In Format Shown Below or As A One Position Alpha Character
Choice 1: Date MM/CCYY
Choice 2: (B) null
Fill-in (15) - Requested As A One Position Alpha Character
Choice 1: (A) and
Choice 2: (B) null
Fill-in (16) Requested As A One or Two Position Number
Choice 1: a number between 5 and 40 representing the percentage of withholding
Choice 2: (B) null
Fill-in (17) - Requested As A One Position Alpha Character
Choice 1: (A) withheld
Choice 2: (B) null
Fill-in (18) - Requested As A One Position Alpha Character
Choice 1: (A) beginning
Choice 2: (B) null
Fill-in (19) Requested As A Date In Format Shown Below or As A One Position Alpha Character
Choice 1: Date MM/CCYY
Choice 2: (B) null
VTW002 Voluntary Tax Withholding Implemented With CMA Payment (V02)
(Requested)
Caption: Your Benefits
We will withhold (1) from (2) benefit for (3) . Thereafter, we will withhold (4) each month. (5) (6) .
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: Voluntary Tax Withheld
Fill-in (2) - Systems Generated
Choice 1: your
Choice 2: Beneficiary's Name possessive
Fill-in (3) - Systems Generated
Choice 1: MM/CCYY
Fill-in (4) - Systems Generated
Choice 1: Voluntary Tax to be Withheld
Fill-in (5) - Systems Generated
Choice 1: We will continue to withhold until
Choice 2 : null
Fill-in (6) - Systems Generated
Choice 1: MM/CCYY
Choice 2 : null
VTW003 Voluntary Tax Withholding Implemented With PMA Payment (V03)
(System Generated)
Caption: Your Benefits
We will withhold (1) from (2) next check. This check is the money (3) due through (4) .
Fill-in values:
Fill-in (1)
Choice 1: Money Fill-ins
Fill-in (2)
Choice 1: your
Choice 2: Beneficiary's Name possessive
Fill-in (3)
Choice 1: you are
Choice 2: he is
Choice 3: she is
Fill-in (4)
Choice 1: Date
VTW004 Beneficiary Requests We Stop Withholding for a Specific Period (V05)
(Requested)
Caption: Your Benefits
We will not withhold money for voluntary Federal tax withholding from (1) monthly Social Security benefits beginning (2) through (3) .
Fill-in values:
Fill-in (1) Systems Generated
Choice 1: Beneficiary's Name possessive
Choice 2: your
Fill-in (2) Requested As A Date In Format Shown Below
MM/CCYY
Fill-in (3) - Requested As A Date In Format Shown Below
MM/CCYY
VTW005 VTW Requested But Net Benefits Less Than Amount Calculated For VTW (V06)
(Requested)
Caption: Your Benefits
Since the amount due (1) (2) (3) is not enough for voluntary Federal tax withholding, we cannot honor your request.
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: you
Choice 2: Beneficiary's Name
Fill-in (2) - Requested as a one position choice letter
Choice 1: (A) through
Choice 2: (B) for
Choice 3: (C) from
Choice 4: (D) Null
Fill-in (3) - Requested As A Date In Format Shown Below
MM/CCYY
VTW006 Beneficiary Requests We Stop Voluntary Tax Withholding - No Future Request (V04)
(Requested/Generated)
Caption: Your Benefits
As you asked, we will stop voluntary Federal tax withholding from (1) monthly Social Security benefit beginning (2) .
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: you
Choice 2: Beneficiary's Name
Fill-in (2) Requested As A Date In Format Shown Below
MM//CCYY
VTW008 VTW Stopped - Beneficiary Suspended, Deferred or Terminated (V07)
Caption: Your Benefits
(Requested)
Since (1) no longer receiving benefits, we cannot continue to honor your request for voluntary Federal tax withholding. (2)
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: you are
Choice 2: Beneficiary's Name is
Fill-in (2) - Systems Generated
Choice 1: When benefits are again payable, we will resume withholding the percentage you requested.
Choice 2: If you ever become entitled again, voluntary tax withholding will have to be requested again.
Choice 3: If he ever becomes entitled again, voluntary tax withholding will have to be requested again.
Choice 4: If she ever becomes entitled again, voluntary tax withholding will have to be requested again.
VTW009 Change in Benefit Amount Results in a Change in the Amount of VTW (V08)
Caption: Your Benefits
(Systems Generated or Requested)
We will continue to withhold money for voluntary Federal tax withholding as you requested.
VTW011 Administrative Error - Voluntary Tax Erroneously Withheld/Current And Prior Years (V13) (V09)
Caption: Your Benefits
(Requested)
Although (1) never asked us to withhold any money from (2) Social Security benefits for voluntary Federal tax withholding, we withheld (3) . We are refunding (4) to (5) for the current year. To receive the (6) we withheld for the previous year, (7) must contact the Internal Revenue Service. We are sorry if our error caused (8) any inconvenience.
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: you
Choice 2: Beneficiary Name
Fill-in (2) - Systems Generated
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (3) - Requested As A Money Amount In Format $$$$$.¢¢
Amount of VTW erroneously withheld
Fill-in (4) - Requested As A Money Amount In Format $$$$$.¢¢
Amount of VTW erroneously withheld for the current year
Fill-in (5) - Systems Generated
Choice 1: you
Choice 2: him
Choice 3: her
Fill-in (6) - Requested As A Money Amount In Format $$$$$.¢¢
Amount of VTW erroneously withheld for prior year
Fill-in (7) - Systems Generated
Choice 1: you
Choice 2: he
Choice 3: she
Fill-in (8) - Systems Generated
Choice 1: you
Choice 2: him
Choice 3: her
VTW012 Administrative Error - Voluntary Tax Erroneously Withheld/Prior Year Only (V12) (V09)
Caption: Your Benefits
(Requested)
Although (1) never asked us to withhold any money from (2) Social Security benefits for voluntary Federal tax withholding, we withheld (3) . To receive the money we withheld, (4) must contact the Internal Revenue Service. We are sorry if our error caused (5) any inconvenience.
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: you
Choice 2: Beneficiary Name
Fill-in (2) - Systems Generated
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (3) - Requested As A Money Amount In Format $$$$$.¢¢
Amount of VTW erroneously withheld in 1234.56 format
Fill-in (4) - Systems Generated
Choice 1: you
Choice 2: he
Choice 3: she
Fill-in (5) - Systems Generated
Choice 1: you
Choice 2: him
Choice 3: her
VTW021 Administrative Error - Voluntary Tax Erroneously Withheld/Current Year Only (V11) (V09)
Caption: Your Benefits
(Requested)
Although (1) never asked us to withhold any money from (2) Social Security benefits for voluntary Federal tax withholding, we withheld (3) . To receive the money we withheld, (4) must contact the Internal Revenue Service. We are sorry if our error caused (5) any inconvenience.
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: you
Choice 2: Beneficiary Name
Fill-in (2) - Systems Generated
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (3) - Requested As A Money Amount In Format $$$$$.¢¢
Amount of VTW erroneously withheld
Fill-in (4) - Systems Generated
Choice 1: you
Choice 2: he
Choice 3: she
Fill-in (5) - Systems Generated
Choice 1: you
Choice 2: him
Choice 3: her
VTW022 Administrative Error - Amount Withheld More Than Requested/Prior Year (V15)
(Requested)
Caption: Your Benefits
We withheld (1) too much from (2) Social Security benefit for voluntary Federal tax withholding. To receive the money we withheld, (3) must contact the Internal Revenue Service. We are sorry if our error caused (4) any inconvenience.
Fill-in values:
Fill-in (1) – Request As A Money Amount In Format Shown Below
Amount in excess of what should have been withheld in $$$$$.¢¢ format
Fill-in (2) - Systems Generated
Choice 1: your
Choice 2: Beneficiary Name possessive
Fill-in (3) - Systems Generated
Choice 1: you
Choice 2: he
Choice 3: she
Fill-in (4) - Systems Generated
Choice 1: you
Choice 2: him
Choice 3: her
VTW023 Administrative Error - Amount Withheld More Than Requested/Current And Prior Year (V16)
(Requested)
Caption: Your Benefits
We withheld (1) too much from (2) Social Security benefit for voluntary Federal tax withholding. To correct this error, we will begin withholding at the rate (3) requested. To receive the (4) we withheld for the previous year, (5) must contact the Internal Revenue Service. We are sorry if our error caused (6) any inconvenience.
Fill-in values:
Fill-in (1) – Request As A Money Amount In Format Shown Below
Amount in excess of what should have been withheld in $$$$$.¢¢ format
Fill-in (2) - Systems Generated
Choice 1: your
Choice 2: Beneficiary Name possessive
Fill-in (3) - Systems Generated
Choice 1: you
Choice 2: he
Choice 3: she
Fill-in (4) – Requested As A Money Amount In Format Shown Below
Amount in excess withheld for the prior year in $$$$$.¢¢ format
Fill-in (5) - Systems Generated
Choice 1: you
Choice 2: he
Choice 3: she
Fill-in (6) - Systems Generated
Choice 1: you
Choice 2: him
Choice 3: her
VTW024 Administrative Error - Amount Withheld More Than Requested/Current Year ( V14)
(Requested)
Caption: Your Benefits
We withheld (1) too much from (2) Social Security benefit for voluntary Federal tax withholding. (3) We are sorry if our error caused (4) any inconvenience.
Fill-in values:
Fill-in (1) – Requested As A Money Amount In Format Shown Below
Amount in excess of what should have been withheld in $$$$$.¢¢ format
Fill-in (2) - Systems Generated
Choice 1: your
Choice 2: Beneficiary Name possessive
Fill-in (3) – Requested As A One Position Alpha Character
Choice 1: (A) To correct this error, we will begin withholding at the rate he requested.
Choice 2: (B) To correct this error, we will begin withholding at the rate she requested.
Choice 3: (C) To correct this error, we will begin withholding at the rate
Choice 4: (D) We are refunding this amount to you.
Choice 5: (E) We are refunding this amount to her.
Choice 6: (F) We are refunding this amount to him.
Fill-in (4) - Systems Generated
Choice 1: you
Choice 2: him
Choice 3: her