TN 25 (04-14)

GN 02401.908 Description of Forms or Letters Used By the Department of the Treasury (Treasury) Handwriting Analysis Unit

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).

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 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.

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)

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:

  1. Questioned (detailing which checks were reviewed),

  2. Standard (detailing what was used for signature comparison), and

  3. Report (detailing the results of the handwriting analysis).

For an example of a completed HAL, see NL 03001.065.


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http://policy.ssa.gov/poms.nsf/lnx/0202401908