POMS Reference

This change was made on Jun 15, 2018. See latest version.
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GN 02401.908: Description of Forms or Letters Used or Reviewed By the Department of the Treasury (Treasury) Questioned Documents Branch (QDB)

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  • Effective Dates: 04/21/2014 - Present
  • Effective Dates: 06/15/2018 - Present
  • TN 25 (04-14)
  • TN 35 (06-18)
  • GN 02401.908 Description of Forms or Letters Used By the Department of the Treasury (Treasury) Handwriting Analysis Unit
  • GN 02401.908 Description of Forms or Letters Used or Reviewed By the Department of the Treasury (Treasury) Questioned Documents Branch (QDB)
  • A. Form FMS-1133
  • Form FMS-1133 (Claim Against the United States for the Proceeds of a Government Check) is a two-page form created by Treasury.
  • * Treasury generates the form based on SSA’s input of a nonreceipt or stop payment action.
  • * The form contains questions the beneficiary or recipient need to complete to assist Treasury in determining if the check in question is forged.
  • * Treasury will not provide the form when SSA uses a non-permanent stop code to request a photocopy (e.g., K-stop or L-stop) or when requesting status only (e.g., M-stop).
  • Treasury generates Form FMS-1133 (Claim Against the United States for the Proceeds of a Government Check) when the Social Security Administration (SSA) inputs a nonreceipt or stop payment request for Title II or Title XVI checks. The form contains questions the beneficiary, recipient or representative payee must complete in order to assist Treasury in determining if the check in question is forged.
  • If the beneficiary, recipient, or representative payee loses or does not receive the form, the field office (FO), Teleservice center (TSC) or program service center (PSC) may do a one-time print of the FMS-1133 from the Treasury Check Information System (TCIS). If FO or TSC personnel need additional printed forms, contact the Regional Office through normal communication (vHelp); PSC personnel can contact their Operations Analysis Staff, or contact Treasury at 855-868-0151, if necessary. The form is available for print until Treasury receives the completed FMS-1133.
  • Treasury will not provide the form when SSA uses a non-permanent stop code to request a certified photocopy (L-stop).
  • NOTE: Do not input regular photocopy or status requests through the SSA system because this information is available on TCIS.
  • B. Form FMS-3858
  • Form FMS-3858 (Claims Document) is a white Treasury routing form which contains essential information about the alleged missing check (number, symbol, amount, and date), the payee’s name and address, the stop code input by SSA, Treasury’s status code response, etc.
  • Treasury generates the white routing Form FMS-3858 (Claims Document) when responding to a nonreceipt, stop payment, or certified photocopy input. The form contains essential information about:
  • * the alleged missing Title II or Title XVI check (number, symbol, amount, and date);
  • * the beneficiary, recipient, or representative payee’s name and address;
  • * the stop code input by SSA, Treasury’s status code response; and
  • * other pertinent check information.
  • Treasury uses this form when responding to a nonreceipt, stop payment, photocopy or check status input. Depending upon the type of input submitted, an actual check photocopy would be attached to the FMS-3858. For example:
  • * When a nonreceipt or stop payment is input and the check is cashed, Treasury sends an FMS-3858 along with a photocopy of the cashed check;
  • * When an uncertified photocopy (K-stop) is input, Treasury sends an FMS-3858 along with a photocopy of the cashed check;
  • * When a certified photocopy (L-stop) is input, Treasury sends an FMS-3858 along with a certified photocopy of the cashed check; and
  • * When a status request (M-stop) is input, Treasury only sends the FMS-3858 with the status of the check (i.e., cashed or still outstanding).
  • For more information about the form, see GN 02406.160B and SM 01315.212.
  • C. Request for Check Information and Payee Signature Letter
  • Effective immediately, we will use the letter for check information and payee signature to request a handwriting analysis from the Department of the Treasury’s (Treasury) Questioned Document Staff. If any other document is used, Treasury will take no action and return the unprocessed form to the sender. The technician needs to process each limited payability questioned check as outlined below.
  • * Prepare the request letter for each limited payability check in question.
  • * Have beneficiary or recipient complete the questions regarding the check and sign the signature boxes.
  • * If it is necessary to mail the documents to the beneficiary or recipient, make sure a return envelope is included to ensure the return of the documents to the appropriate field office or processing center.
  • * Upon receipt of the completed letter, use the handwriting analysis cover letter to list the check(s) submitted for review under the questioned items section of the notice.
  • * Provide any additional information requested by Treasury to assist in their analysis.
  • Treasury generates an FMS-3858, along with a photocopy of the cashed check, when a technician inputs:
  • * a nonreceipt or stop payment of the original check and the check was cashed;
  • * nonreceipt of a replacement check and the check was cashed; or
  • * certified photocopy (L-stop).
  • See details:
  • * NL 03001.055 Request for Check Information and Payee Signature Letter
  • * NL 03001.060 Cover Letter for Limited Payability Cases Requesting Handwriting Analysis from the Department of the Treasury (Treasury)
  • In addition, Treasury returns the form and photocopy of the check when:
  • * the previously gave SSA a credit for a check that has since been cashed; or
  • * they issued a replacement check and the original check is subsequently cashed (possible overpayment situation).
  • C. Check information and payee signature (CIPS) letter
  • SSA sends the CIPS letter to the beneficiary, recipient, or representative payee to obtain recent signatures to present to Treasury’s Questioned Documents Branch (QDB) for a handwriting analysis determination.
  • Treasury’s QDB uses the CIPS letter to compare the recent signatures submitted by SSA and returns a decision for additional processing.
  • NOTE: If the SSA technician uses any other form or document to obtain signatures, Treasury takes no action on the request and returns the unprocessed form to the sender.
  • D. Handwriting Analysis Letter (HAL) final report
  • The HAL is the final report from Treasury. The report must appear on Treasury letterhead. It describes the results of the handwriting analysis performed by the Questioned Documents Staff. The letter normally has three headings:
  • * Questioned (detailing which checks were reviewed),
  • * Standard (detailing what was used for signature comparison), and
  • * Report (detailing the results of the handwriting analysis).
  • The HAL is the final report from the Treasury QDB. The report must appear on Treasury letterhead. It describes the results of the handwriting analysis performed by the document examiner in the QDB. The letter normally has three headings:
  • * Questioned (details which checks were reviewed);
  • * Standard (details what was used for signature comparison); and
  • * Report (details the results of the handwriting analysis).
  • For an example of a completed HAL, see NL 03001.065.
  • E. References
  • * GN 02406.160 When to Use Forms FMS-1133 and FMS-3858
  • * SM 01315.210 When Treasury Will Send a FMS-3858
  • * SM 01315.212 How to Read a FMS-3858
  • * SM 01315.213 How to Process a FMS-3858/FMS-1133
  • * NL 03001.055 Request for Check Information and Payee Signature Letter
  • * NL 03001.060 Cover Letter for Limited Payability Cases Requesting Handwriting Analysis from the Department of the Treasury (Treasury)