Mailroom personnel will date stamp all forms received on the face; i.e., CMS-1739's
and all types of CMS-40's. DO NOT STAPLE, PUNCH HOLES OR OTHERWISE MUTILATE THEM.
Any correspondence received with the form should be sent to the module HI-SMI clerk,
and should be attached to the form with a paper clip. If folders are needed, they
will be requested by the HI-SMI clerk.
The prepunched forms CMS-40F received each month from OCRO will be kept in a holding
file in the mailroom. The mailroom will screen the forms CMS-1739 against the CMS-40F
holding file. Send the CMS-40F, SSA Publication No. 05-10014 and a return envelope
to the beneficiary if: (1) a United States address is not shown, and, (2) the CMS-1739
contains no notations or is not accompanied by correspondence, other than a letter
of transmittal. To ensure that the CMS-40F is not returned prior to the beginning
of the beneficiary's initial enrollment period, do not mail it sooner than 5 days
before the start of the enrollment period.
If a change of address is received with a Form CMS-1739, prepare a new CMS-40F to
show the new address since addresses on computer-prepared CMS-40F's cannot be corrected.
Send the CMS-1739 and any correspondence to the module so action can be taken to correct
the address on the MBR. Destroy all unused computer-generated forms CMS-40F not removed
from the holding file, in the month after the end of the initial enrollment period.
Since the CMS-1739 may serve as a protective filing it should be retained for 60 days
after the last month of the enrollment period. If the CMS-40F is returned, both forms
should be forwarded to the module HI-SMI clerk. The CMS-1739 should be destroyed if
the CMS-40F is not returned and 60 days have passed beyond the end of the enrollment