Follow the steps below to complete the Receipt Book Log each time the SSA-1395-BK
Receipt Book is either issued or returned.
IMPORTANT: The Remittance Supervisor is responsible for completing all entries on the log with
the exception of REP SIGNATURE block and REP INITIALS block.
The Remittance Supervisor retains the log with SSA-3944, Master Control Roster. See
GN 02403.095.
Complete the Receipt Book Log as follows:
Enter date book is given to the interviewer.
Enter first and last serial numbers of unissued receipts contained in the SSA-1395-BK
receipt book.
Sign name (person receiving the book) upon receipt of the book from the Remittance
Supervisor.
Enter date book is returned from the interviewer.
Enter the number(s) of the receipt(s) which were used by the interviewer.
Sign initials (person receiving the book) indicating agreement with the log entries.
Sign your name to acknowledge receipt of the book back from the representative.