Transcription of INSTRUCTIONS for 1199A Form - DOL
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INSTRUCTIONS for 1199A Form - DOL
INSTRUCTIONS for 1199A Form Section 1 (To be completed by Payee) A. Type or print your name, address and telephone number. B. Type or print your name. C. Type or print your 9-digit social security number. D. Check the type of account you want your funds deposited into. E. Type or print the account number you want your funds deposited into F. (Completed by Agency) G. Leave Blank Sign and date the form. Section 2 (Completed by Agency) Section 3 (To be completed by your financial institution) Standard Form 1199A (EG) OMB No. 1510-0007 (Rev. August 2012) Prescribed by Treasury Department DIRECT DEPOSIT SIGN-UP FORM Treasury Dept.
The financial institution will information is also stated on beneficiary/annuitant award letters and verify the information in Sections 1 and 2, and will complete Section 3. other documents from the Government agency. The completed form will be returned to the Government agency
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