Figure 3.11.25-1 provides an illustrated example of a completed Form 3465, Adjustment Request. The original DLN box is completed with 00602-052-00000-8.Taxpayer's Name or Name Control box shows Jack Alder Inc. as the name.In the Routing box the Accounts Management box is checked.The EIN or SSN box shows 00-6789000 as the EIN.The Period ending box shows 1712.The Form No. box shows CT-2.The Action requested box has the Transfer credit to box shows EIN/SSN 00-6789000, name control of Jack, MFT/Period of 01/2012 and amount is $150.00.Remarks box has Transfer overpayment of $150 to Form 941 for Quarter Ending December 31, 2020.The Signature of Requestor box shows John Spruce.The Unit box shows C&E Unit 2.The Phone extension. box shows 9000.The Date box shows 02/15/21.