Forms Quick Reference Guide
FormNumber / Form Title / Shared Services Instructions
17 / Stamp Requisition/
Stamp Return / Send to SDO/SDN as specified in F-1 for stock returned/shipped or submitted for destruction. Keep office copies as required. Do not send to the USPS Scanning and Imaging Center.
17-TX / Accountable Items Returned Stamp Distribution Network / Form will be eliminated and replaced with Form 17. Do not send to the Scanning and Imaging Center.
178 / Specific Travel Order – Relocation & Relocation Agreement / The gaining office mails the completed Form 178, approved by the local PCES manager, with the corresponding Form 8059, to Relocation Management Section, 2700 Campus Dr, San Mateo, CA 94497-9400.
571 / Discrepancy of $100 or More in Financial Responsibility / Follow distribution instructions on the form or local policy. Do not send to the Scanning and Imaging Center.
834/835 / Originating Register/COD Mail Report / Send survey form at the close of each postal quarter to District Statistical Programs Office. Do not send to the Scanning and Imaging Center.
1011 / Travel Advance Request and Itinerary Schedule / Mail completed Form 1011 for bargaining unit employees to the Scanning and Imaging Center. Form requires manager approval. See F-15, Appendix C.
1012 / Travel Voucher / Employees claiming reimbursement for travel expenses using Form 1012 must use eTravel. Do not submit Form 1012 to the Scanning and Imaging Center. See F-15.
1164 / Claim for Reimbursement / Employees claim for reimbursement for travel expenses using Form 1164 must use eTravel. Do not send to the Scanning and Imaging Center. See F-15.
1164-A / Claim for Reimbursement for Postal Supervisors / Mail completed Form 1164A to the Scanning and Imaging Center. Requires manager approval. See F-15.
1221 / Advanced Sick Leave Authorization / Mail completed Form 1221 to the Scanning and Imaging Center. Requires approval by installation head.
1270 / Idea Proposal / Mail completed Form 1270 to the Scanning and Imaging Center.
1312 / Local Transportation Payments / Pay locally. Do not send to the Scanning and Imaging Center.
1412-A / Daily Financial Report / Used for MOVES or as back-up for POS and IRT sites. Keep Form 1412-A in the local office. Do not send to the Scanning and Imaging Center.
1412-B / Daily Financial Report: Sport Offices / Used for daily financial reporting through the MDCD scanner. Keep Form 1412-B in the local office. Do not send to the Scanning and Imaging Center.
1538 / Box Rent Receipt / Keep in local office. Host post office keeps the duplicate copy from each contract station. Do not send to the Scanning and Imaging Center.
1555 / Statement of Account (final) / Mail final form to IT/ASC, Attn.: Accounting Reconciliation Branch, 2825 Lone Oak Parkway, Eagan, MN 55121-9671.
Form
Number / Form Title / Shared Services Instructions
1556 / Suspense Items Support Information / Eliminated with implementation of SAFR.
1608 / Emergency Salary Authorization and Receipt / Form 1608 when used for non-grievance hours adjustment advances will be mailed to the Scanning and Imaging Center along with Form 2240 or Form 2240-R. If the revised version of Form 2240 with Salary Advance information appearing on the top of the form is available, submit this form to the Scanning and Imaging Center instead of Form 1608 and older versions of Form 2240. File locally when Form 1608 is issued for a lost/missing salary check.
1782 / Training Request and Authorization / Send completed Form 1782 to Accounting Service Center, 2700 Campus Dr., San Mateo, CA 94497-9431. Do not send to the Scanning and Imaging Center. This procedure has not changed.
1839 / Payment Record for Carrier Drive Out Agreements / Mail completed and approved Form 1839 to the Scanning and Imaging Center.
1902 / Justification for Billing Accounts Receivable / Mail completed and approved Form 1902 to the Scanning and Imaging Center.
1908 / Financial Adjustment Memorandum / Maintain locally to support employee trust and suspense items.
2130 / Claim for Loss / Send completed Form 2130 to the District Manager Finance for adjudication. Do not send to the Scanning and Imaging Center.
2131 / Uncollectible Check Report / Following migration the form will no longer be used in the field.
2198 / Tort Claim / · Claims Adjudicated by District Tort Claims Coordinator: submit 8230 to the Scanning and Imaging Center; if the payment amount is greater than $5,000, attach a copy of the Law Department authorization letter. Retain all supporting documentation according to current guidelines.
· Claims between $5,000 and $50,000 (and Denial for Claims under $5,000): Form 8230 is not required. Submit Form 2198 and supporting documentation to:
USPS ASC
Tort Claims Processing
PO Box 80471
St. Louis, MO 63180-9471
· Above $50,000: Form 8230 is not required. Continue submitting to National Tort Claim Center, via your District Tort Claims Coordinator.
2240 / Pay, Leave, or Other Hours Adjustment Request / Supervisors/Postmasters in TACS offices enter non-grievance adjustments via the TACS adjustment module-AdjustPay (within 14 pay periods of current period). Mail all others with any required support records to the Scanning and Imaging Center. Requires supervisor and employee signature.
2240-R / Rural Pay or Leave Adjustment Request / Mail completed Form 2240-R to the Scanning and Imaging Center. A copy of the original time card may be included. Do not send the original time card. Requires supervisor and employee signature.
2944 / Receipt for Customs Duty Mail / Keep Form 2944 in local office. Do not send to the Scanning Imaging Center.
3036 / Record of Stamp Stock Requisitions / Eliminated.
3083 / Trust Accounts Receipts and Withdrawals / Keep Form 3083 in local office. Do not send to the Scanning and Imaging Center.
3176 / Bank Transaction Record / Eliminated with implementation of SAFR.
3210 / Interim Receipt for Stamp Stock Redemption / Eliminated with implementation of SAFR.
3236 / Uniform Allowance Cap Disbursements / Pay locally. Do not send to the Scanning and Imaging Center.
3238 / Stamp & Stamp Paper Destruction Certificate / Eliminated. Replaced with revised Form 17 with implementation of SAFR.
3239 / Payroll Deduction Authorization to Liquidate Postal Service Indebtedness / Mail completed and approved Form 3239 to the
Scanning and Imaging Center. Include invoice number on Form 3239.
3293 / Retail Vending Credit Examination / File completed form in the record of stamp credits. Do not send to the Scanning and Imaging Center.
3294-C / Cash Credit Count and Summary / File completed form in the record of stamp credits. Do not send to the Scanning and Imaging Center.
3294-P / Cash and Stamp Stock Count and Summary / File completed form in the record of stamp credits. Do not send to the Scanning and Imaging Center.
3309 / Advice of Shipment / Eliminated with implementation of SAFR.
CF 3419-A / Customs Clearance Entry Form / Units transmitting an electronic 1412 via POS ONE, IRT will retain the form locally. After the close of the reporting period, submit all Customs Forms 3419-A to U.S. Customs Service, Mail Entry Team, 6026 Lakeside Blvd., Indianapolis, IN 46278-1998.
All manual reporting post offices, including MOVES sites, will submit Form 3419A Customs Tag, Form 2932 Customs Collection Summary and payment to the customs agency daily at: US Customs Service, PO Box 360840, Pittsburgh, PA 15250-6840. Do not send to the Scanning and Imaging Center.
3533 / Application and Voucher for Refund of Postage, Fees and Services / Local refunds are not to exceed $500. For refunds greater than $500 and units without payment capability, mail completed Form 3533 to the Scanning and Imaging Center. Destroy spoiled meter strips and certify their destruction prior to submission of the form. For local refund payments, enter AIC 100 and the corresponding refund AIC on PS 1412. For refunds processed through the USPS Scanning and Imaging Center (> $500), enter AIC 280 and the corresponding refund AIC on PS 1412.
NOTE: Do not submit refunds for PVI or Dinero Seguro to the Scanning and Imaging Center. These refunds will be paid locally regardless of refund amount. Retain documentation locally.
3601-C / Postage Meter Activity Report / Mail completed Form 3601-C to the Scanning and Imaging Center for withdrawals of any manually-set customer meters and any Postalia or Hasler CMRS customer meters. Retain Form 3601-C in office records for all Neopost and Pitney Bowes CMRS meters and for all meter installations and transfers. See policy on Postage Meter Refunds. For detailed information on OMAS meters, see the Transition section at the front of this guide.
3602-PO / Postage Collected Through Post Office Meter / Retained at local office. Usage will be reconciled daily against AIC 110 balance on 1412.
3603 / Receipt for Postage Meter
Settings / Forward manually prepared forms for manually set customer meters (settings and examinations) to: USPS, Eagan IT/ASC, Postage Meters Team, 2825 Lone Oak Pkwy, Eagan, MN 55121-9210. Do not send to the Scanning and Imaging Center. For OMAS manually set meters, submit a copy of Form 3603 in an OMAS batch report for weekly input to the Scanning and Imaging Center. For detailed information on OMAS meters, see the Transition section at the front of this guide.
3610 / Record of Meter Settings / Only used for recording OMAS meters. Retain Form 3610 in local office for manually-set OMAS meters. Do not send to the Scanning and Imaging Center.
3613 / Refunds from Advance Deposit Account / Eliminated. Use Form 3533 for all refunds.
3634-G / Transferring Postage to or Canceling Penalty Mail Postage / For OMAS manually set meters, submit a copy of Form 3634-G in an OMAS batch report for weekly input to the Scanning and Imaging Center.
3637-G / Batch Header for Official Mail / Mail completed OMAS batch header and supporting forms, e.g. 3634-G, to the Scanning and Imaging Center. Retail unit reporting period for submission of batches to the Scanning and Imaging Center ends on Friday of week 3 of each accounting period.
3958 / Main & Reserved Stock Transaction Record / Keep Form 3958 in local office. Do not send to the Scanning and Imaging Center.
3959 / Stamp Stock Recap / Eliminated with implementation of SAFR.
3970-T / Donated Leave Transfer / Mail completed Form 3970-T to the Scanning and Imaging Center.
5006 / Dinero Seguro Payment Order Application / Keep at local unit. Do not send to the Scanning and Imaging Center.
6401 / Money Order Inquiry / Send to St. Louis Accounting Service Center. See instructions on the form. The form will be revised for submission to the Scanning and Imaging Center.
7355 / Cleaning Agreement / For agreements with a 1 year or longer term, payments must be processed by the St. Louis ASC. See procedures in Policy and Procedure section.
7381 / Requisition for Supplies, Services, or Equipment / Keep approved Form 7381 locally with supporting supply receipt documentation. Do not send to the Scanning and Imaging Center.
8038/8039 / Back Pay and Lump Sum Awards / Mail approved forms and supporting documents to the Eagan ASC. Manager Human Resources approval is required.
8059 / Request for Relocation Management Firm (RMF) Service / The gaining office mails the completed Form 8059, approved by the local PCES manager, with the corresponding Form 178, to the Relocation Management Section, 2700 Campus Dr, San Mateo, CA 94497-9400.
8105-A
8105-B / Funds Transaction Transfer Report
Suspicious Transaction Report / Mail completed form to St Louis Accounting Service Center daily. See instructions on the form.
8127 / Rural Carrier Supplemental Payment / Mail completed Form 8127 to the Scanning and Imaging Center. Requires approval by Operations Programs Support. See Policies and Procedures section.
8230 / Authorization for Payment / Complete the payment authorization form to pay all invoices for supplies and services, OSHA Payments, and applicable tort claims. Mail the completed form and original invoice/required documentation to the Scanning and Imaging Center. Instructions for properly completing the PS 8230 are provided on pages 154 and 154.01. No entries are to be made to the 1412.
8231 / Vendor Payment 1099 Reporting Form / Complete 8231 for one time emergency or sole source payments via cash or money order for services. Mail completed form to the Scanning and Imaging Center the same day payment is made. Proper entries must be made to 1412.
8232-X / Payment for Personal Services Contracts / Certifying officials must fax (the front only of) the properly completed form with a fax cover sheet and the supporting invoice to the Scanning and Imaging Center at 608-741-4969 no later than COB Friday of week two of the pay period. The original form 8232-X and supporting documentation must be filed locally and retained for 90 days.
N/A / Request for Incentive Payment and/or USPS Waiver Offer for Purchase of Right-Hand Drive Vehicles / Send the completed request to the District Finance Office for verification. The District Finance Office mails completed forms and supporting documentation to the Scanning and Imaging Center.
N/A / Debit/Credit Card Chargeback/Retrieval Requests / Upon request from Shared Services, fax debit/credit receipts to (651) 406-3847.
N/A / International Reply Coupons / Send to SDO/SSC supported by Form 17. SDO/SSC will consolidate the coupons and forward to the Eagan ASC. Do not send to the Scanning and Imaging Center.
N/A / Miscellaneous Correspondence / Mail miscellaneous correspondence pertaining to Shared Services/Accounting to the Scanning and Imaging Center.
N/A / Money Order Vouchers / Manually reporting units send money order vouchers directly to St. Louis Accounting Service Center no later than Monday of each week; Tuesday if Monday is a holiday; SPORT offices must retain the vouchers locally for 1 year.
N/A / MO Post Audit Request / Eliminated.
Form
Number / Form Title / Shared Services Instructions
N/A / Proof of Trust Accounts / Eliminated.
N/A / 1099 Vendor Reporting Log / Following migration to SS/A, send the log for the prior quarter to the Scanning and Imaging Center. Subsequent payments for 1099 reportable expenses must be reported on PS Form 8231. Effective June 1, 2003, each post office utilizing contract cleaners should refer to page 51 for applicable procedures.