MEMORANDUM

2015 Memorandums

IM-#1      02/03/15

DEPARTMENT OF SOCIAL SERVICES
FAMILY SUPPORT DIVISION
P.O. BOX 2320
JEFFERSON CITY, MISSOURI
TO:
ALL FAMILY SUPPORT DIVISION OFFICES
FROM:
ALYSON CAMPBELL, DIRECTOR
SUBJECT:
IM-214 AFFIDAVIT FOR REPLACEMENT CHECK, IM-215 AFFIDAVIT OF FORGERY FORMS REVISION, AND IM-206 CHECK TRANSMITTAL FORMS INSTRUCTIONS
FORMS MANUAL REVISION #1

DISCUSSION:

The purpose of this memorandum is to remind staff of the appropriate procedures regarding replacement check issues, to notify staff of updates made to the IM-214 Affidavit for Replacement Check and the IM-215 Affidavit of Forgery and to share instructions for these forms and for the IM-206 Check Transmittal.

It is the responsibility of Family Support Division staff to initiate requests for replacement checks when participants report a check was not received, was damaged or lost, or may have been forged. Do not refer participants to the Division of Finance and Administrative Services.

The IM-214 and IM-215 forms are revised as follows:

For further information regarding replacement checks, review Income Maintenance memorandum IM-16 Check Replacement and Interim Reimbursement Procedures dated January 29, 2001 Check Replacement and Interim Reimbursement Procedures.

Instructions for completion of the IM-214 and IM-215 forms have been updated to reflect these changes and added to the online Income Maintenance Forms Manual.

Any checks returned to a Family Support Division office, such as payments made after a participant left a nursing home or previously replaced checks that were later found, must be accompanied by the IM-206 Check Transmittal ledger when submitted to DFAS. The IM-206 has not been revised but instructions for completion of the form have now been added to the Income Maintenance Forms Manual. Review the complete instructions to ensure proper procedures are followed.

NECESSARY ACTION:

ATTACHMENTS:

AC/cb/mah/tb


2015 Memorandums