TN 13 (05-03)

GN 02403.007 FO Receipt Process -- Automated and Manual

A. Introduction - FO Receipt Process

To acknowledge receipt of any acceptable remittance received in the FO, the interviewer enters the remittance information into DMS.

B. Process - FO Receipt Process

The remittance is entered into the system using the Field Office Remittance Input (RFOR) screen. The system produces a remittance receipt, which is given or mailed to the remitter. The system also produces payment coupons that are forwarded to MATPSC with the remittance, or credit card authorization. See GN 02403.007 Exhibit F below for example of coupon. For other remittances, such as fees or CMS lockbox payments (see GN 02403.030), DMS will generate a forwarding instruction sheet which provides the address where the remittance should be forwarded.

Any subsequent correction to a receipt for other than the remittance amount and credit amount is done via the Correct Field Office Receipt (RCFR) screen. (See MSOM 003.022.) For corrections to remittance and credit amount fields or deletions of FO receipt items, only FO management (i.e., staff assistant, supervisor, management support specialist, operations officer, and manager) may make the corrections/deletions using the RMCR screen. (See MSOM DMS 004.011.)

NOTE: If the system cannot produce the automated receipt/payment coupon, follow instructions in GN 02403.007I. Each field office should maintain at least one book of SSA-1395s in the event they are needed due to Systems/printer failure or out-of-office receipting.

C. Exhibit - Original Automated Receipt

ORIGINAL AUTOMATED RECEIPT (See GN 02403.007F. for an explanation of each field).

Social Security Administration

 

 ____(1)     

 ____(2)     

Date: ___(3)     

This is a receipt for the  __(4)     today. You should keep this receipt as proof that you     (5)     . Your Receipt number is ___(6)    .

Person Making the Payment: ___(7)    

___(8)    :  __(9)    

___(10)    : ___(11)     (only last 4 digits of SSN will print)

Amount of __(12)     :  ___(13)    

Reason for Payment: __(14)    

Type of Payment: ___(15)    

___(16)    : ___(17)    

___(18)    : ___(19)    

Thank you for ___(20)    .

D. Process – Corrections to Field Office Receipts

1. Remittance still in FO

If the FO realizes that an error was made in the entry of a remittance on the Field Office Remittance Input (RFOR) screen AND the remittance is still in the FO, then:

  • Take corrective action through the Correct Field Office Receipt (RCFR) screen, or, if the change involves the amount, the Manager Correct/Delete FO Receipt (RMCR) screen. (See MSOM DMS 003.022 and MSOM DMS 004.011 for additional information.)

  • After the correction is made, DMS will generate a new payment coupon (see Exhibit E). It is very important to forward the NEW payment coupon along with the remittance to MATPSC. This will ensure that the remittance is posted to the appropriate account.

  • The old (incorrect) payment coupon should be destroyed.

2. Remittance and coupon no longer in the FO

If the FO realizes that an error was made in the entry of a remittance on the RFOR screen AND the remittance has already been forwarded to MATPSC, then:

  • Do not correct through RCFR or RMCR since the coupon has already been mailed to MATPSC.

  • Notify the jurisdictional PSC of the remittance keying error by following the procedures for an Administrative Message (ADM MSG) in MSOM ADMIN 002.001 or MDW procedures in GN 01070.228. The message should inform the PSC about the error that was made and instruct the PSC on what corrective action is necessary. The PSC should be contacted after the erroneous remittance is posted or creates an exception. MATPSC should not be contacted unless they are the jurisdictional PSC.

E. Exhibit - Corrected Automated Receipt

CORRECTED AUTOMATED RECEIPT

Social Security Administration

___(1)      

___(2)      

Date: ___(3)     

This receipt corrects and replaces receipt number ___(4)       that we gave to you earlier. We corrected ___(5)       . You should keep this receipt as proof that you ___(6)       .

Person Making the Payment: ___(7)      

___(8)       :  ___(9)      

___(10)       : ___(11)       (only last 4 digits of SSN will print)

Amount of ___(12)       :  ___(13)     

Reason for Payment: ___(14)      

Type of Payment : ___(15)      

___(16)      : ___(17)     

___(18)      : ___(19)     

Thank you for ___(20)      .

F. Exhibit - Explanation of Each Field on the Automated Receipt

Explanation of Automated Receipt Fields

  1. The street address of the FO that issued the receipt.

  2. The city, state, and ZIP code of the FO that issued the receipt.

  3. The date the FO issued the receipt

  4. If this is an original receipt:

    • “payment you made” or

    • “check you returned”

    If this is a corrected receipt, the RECEIPT NUMBER will be displayed.

  5. If this is an original receipt:

    • “made this payment” or

    • “returned this check”

    If this is a corrected receipt, the field(s) that was corrected will be identified.

  6. If this is an original receipt, the RECEIPT NUMBER will be displayed.

    If this is a corrected receipt:

    • “made this payment” or

    • “returned this check”

  7. The REMITTER"S NAME

  8. “You Made This Payment For” or “You Returned This Check For”

  9. The ACCOUNT NAME

    NOTE: DMS prints the name exactly as it was entered on RFOR, RCFR or RMCR.

  10. When BILL NUMBER is entered, “Bill Number” When the trust fund is title XVI, a BILL NUMBER is not entered, “Account Number.” When the trust fund is not title XVI and BILL NUMBER is not entered, “Claim Number”

  11. The SSN (only last 4 digits of SSN will show), SSN/BIC, ACCOUNT ID, BILL NUMBER and EST DATE

  12. “Payment” or “Returned Check”

  13. The amount of the remittance applied to this account. This is the Credit Amount on the screen.

    NOTE: When the remittance is a savings bond, “FACE VALUE” appears next to the amount.

  14. The reason for the remittance:

    • “Money Saved For (ACCOUNT NAME)

    • “Money Due (ACCOUNT NAME)

    • “To Return Benefits Not Due Because Of Work”

    • “Gift”

    • “Court Ordered Repayment”

    • “To Repay An Overpayment”

    • “To Repay A Medicare Premium”

    • To Repay SSI Claimant Representative Fee

    • “To Return A Benefit Check”

    • “To Pay A Fee”

    • “Returned A Benefit Check With Limited Payability”

    • “Medicare Overpayment”

    • “Returned a Medicare Contractor Check”

    • “To Repay Misapplied Funds”

    • “Payment on a Compromise Offer”

  15. The type of remittance. When REMITTANCE TYPE is foreign currency, the following sentence will be printed:

    “The amount shown is subject to conversion to United States currency before being applied to the account.”

  16. “Date of Check/Money Order”

    NOTE: Fields #16 through #19 are only displayed when a check or money order, or check in U.S. Dollars drawn on a foreign bank, is submitted as a remittance.

  17. The CHECK DATE

  18. “Check/Money Order Number”

  19. The CHECK/MONEY ORDER NUMBER

  20. “Returning the Check” or “your payment”

G. Exhibit - Field Office - Generated Coupon

 

 

 

OMB No 0960-0462

 

Forward the coupon below along with the remittance, if any, and the Field Office Remittance Transmittal and/or Credit Card Field Office Remittance Transmittal to MATPSC:

Social Security Administration
PO Box 3430
Philadelphia, PA 19122-9985

If the remitter is paying by credit card, make sure the credit card portion of the payment coupon is completed.

SSA-53-EP

DETACH HERE. DO NOT STAPLE.

 

 ACCOUNT NUMBER: 123-00-6789-01
JOHN P. SMITH

PAYMENT
AMOUNT:
50.00

  ( ) MASTERCARD   ( )  VISA   ( )  DISCOVER
( ) AMERICAN EXPRESS

 

Credit Card Number

 

Exp Date
___________

Cardholder's Signature
_____________________

 

Date
____________

                                       

           

 

3123456789010000001SMITHJOH200000500000000000000000000OR 000200010010

H. Reference

MSOM DMS 003.006 and MSOM DMS 003.007.

I. Procedure - DMS Cannot Print Receipt/Payment Coupon

When the automated system, due to printer problems, cannot print a receipt/payment coupon, follow these steps:

  • Using the Correct FO Receipt (RCFR) screen, change the account name field to either add or delete the middle initial. Make one up if the remitter does not have one.

  • Annotate the remittance ID field to indicate that the correction was made because the original did not print.

RESULT: The system will send a corrected receipt/payment coupon to the printer; give/mail it to the remitter.

If the system still cannot produc