Fs1522 Template

Fs1522 Template

The FS Form 1522 is a special request form used to seek payment for United States Savings and Retirement Securities. This form is essential for individuals who own these securities and wish to initiate a payment process, whether for personal use or as a legal representative. If you need to fill out this form, click the button below to get started.

Table of Contents

The FS Form 1522 is a crucial document for individuals seeking payment for United States Savings Bonds, Savings Notes, and Retirement Plan Bonds. This form is designed for various parties, including owners, co-owners, and legal representatives of deceased or incompetent owners. It provides a structured way to request payment while ensuring that the necessary information is clearly presented. When filling out the form, you will need to provide specific details about the bonds, such as the names of the registered owners, issue dates, and serial numbers. Additionally, the form includes sections for direct deposit information, requiring a Social Security Number or Employer Identification Number, along with banking details to facilitate the payment process. It's essential to follow the instructions carefully, as any errors or omissions can lead to delays. Moreover, the form requires signatures and may need notarization, especially for bonds with a redemption value exceeding $1,000. Understanding these aspects can help streamline your request and ensure a smoother transaction.

Fs1522 Sample

 

 

 

RESET

 

 

 

 

For official use only:

Customer Name

Case or SR#

Customer No

 

 

 

 

FS Form 1522 (Revised November 2021)

 

 

OMB No. 1530-0028

Special Form of Request for Payment of

United States Savings and Retirement Securities

Where Use of a Detached Request Is Authorized

IMPORTANT: Follow instructions in filling out this form. Making any false, fictitious, or fraudulent claim or statement to the United States is a crime and may be prosecuted. Print in ink or type all information.

1. DESCRIPTION OF BONDS

I am the owner or person entitled to payment of the securities described below, which bear the name(s) of

_______________________________________________________________________________________________

Provide name(s) of the person(s) currently registered/listed on the securities.

ISSUE DATE

SERIAL NUMBER

ISSUE DATE

SERIAL NUMBER

 

 

 

 

ISSUE DATE

SERIAL NUMBER

(If you need more space, attach either a list or FS Form 3500 [see www.treasurydirect.gov].)

2. INSTRUCTIONS FOR DIRECT DEPOSIT PAYMENT

Payee must provide a Social Security Number OR Employer Identification Number:

______________________________________

OR __________________________________________

(Social Security Number of Payee)

(Employer Identification Number of Payee)

________________________________________________________________________________________

(Name/Names on the Account)

Bank Routing No. (nine digits and begins with 0, 1, 2, or 3 ): _______________________________

_________________________________________

Type of Account

(Depositor’s Account No.)

Checking

Savings

___________________________________________________

______________________________

(Financial Institution’s Name)

(Financial Institution’s Phone No.)

FS Form 1522

Department of the Treasury | Bureau of the Fiscal Service

1

3. SIGNATURE

Under penalties of perjury, I certify that:

1.The number shown on this form is my correct Taxpayer Identification Number (or I am waiting for a number to be issued to me); and

2.I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and

3.I am a U.S. person (including a U.S. resident alien).

NOTE: You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.

Certification. If the current redemption value (see Instructions) of your bonds totals $1,000 or less, your signature need not be certified; you may simply sign the form and enclose a current copy of your driver’s license, passport, state ID, or military ID. If the current redemption value of your bonds totals more than $1,000, sign this form in the presence of a notary or certifying officer.

Complete in ink. If required (see “Certification” above), sign in the presence of a notary or certifying officer.

Sign

Here: __________________________________________________________________________________________________

(Signature)

_____________________________________________________

______________________________________________

(Print Name)

 

 

(Social Security Number)

Home Address ________________________________________

______________________________________________

(Number and Street or Rural Route)

 

(Daytime Telephone Number)

_____________________________________________________

______________________________________________

(City)

(State)

(ZIP Code)

(Email Address)

Sign

Here: __________________________________________________________________________________________________

(Signature)

_____________________________________________________

______________________________________________

(Print Name)

 

 

(Social Security Number)

Home Address ________________________________________

______________________________________________

(Number and Street or Rural Route)

 

(Daytime Telephone Number)

_____________________________________________________

______________________________________________

(City)

(State)

(ZIP Code)

(Email Address)

You may leave this blank if your bonds are worth $1,000 or less and you enclose an ID named above in “Certification.”

Instructions to Notary or Certifying Officer: 1. Name(s) of the person(s) who appeared and date of appearance MUST be completed. 2. If a Medallion stamp is used, an original signature is required. 3. Person(s) must sign in your presence.

I CERTIFY that ________________________________________________________________________ , whose identity(ies)

(Names of Persons Who Appeared)

is/are known or proven to me, personally appeared before me this _______________ day of _______________

__________

(Month)

(Year)

at ___________________________________________________ and signed this form.

 

(City, State)

 

________________________________________________________

 

(Signature and Title of Notary or Certifying Officer)

 

________________________________________________________

 

(Name of Financial Institution)

 

________________________________________________________

 

(Address)

 

________________________________________________________

 

(City, State, ZIP code)

 

FS Form 1522

Department of the Treasury | Bureau of the Fiscal Service

2

You may leave this blank if your bonds are worth $1,000 or less and you enclose an ID named above in “Certification.”

Instructions to Notary or Certifying Officer: 1. Name(s) of the person(s) who appeared and date of appearance MUST be completed. 2. If a Medallion stamp is used, an original signature is required. 3. Person(s) must sign in your presence.

I CERTIFY that ________________________________________________________________________ , whose identity(ies)

(Names of Persons Who Appeared)

is/are known or proven to me, personally appeared before me this _______________ day of _______________

__________

(Month)

(Year)

at ___________________________________________________ and signed this form.

 

(City, State)

 

________________________________________________________

 

(Signature and Title of Notary or Certifying Officer)

 

________________________________________________________

 

(Name of Financial Institution)

 

________________________________________________________

 

(Address)

 

________________________________________________________

 

(City, State, ZIP code)

 

INSTRUCTIONS

USE OF FORM – Use this form to request payment of United States Savings Bonds, Savings Notes, Retirement Plan Bonds, and Individual Retirement Bonds.

WHO MAY COMPLETE – This form may be completed by the owner, coowner, surviving beneficiary, or legal representative of the estate of a deceased or incompetent owner, persons entitled to the estate of a deceased registrant, or such other persons who may be entitled to payment under the regulations governing United States Savings Bonds. A minor may sign this form if, in the opinion of the notary or certifying officer, he or she is of sufficient competency to understand the nature of the transaction. An incompetent person may not sign this form.

COMPLETION OF FORM – Print clearly in ink or type all information requested.

ITEM 1.DESCRIPTION OF BONDS – Provide the name(s) of the person(s) shown in the inscription of the bonds for which payment is requested. Describe the bonds by issue date and serial number.

ITEM 2.INSTRUCTIONS FOR DIRECT DEPOSIT PAYMENT

The payee's Taxpayer Identification Number must be provided. Furnish the Social Security Number if the payee is an individual. If an estate, trust, or other entity is involved and IRS has assigned an Employer Identification Number, provide that number. Furnish the name(s) on the account, the account number, the type of account, and the financial institution's name, the routing/transit number which identifies the institution, and the institution's phone number. You may need to contact the financial institution to obtain the routing number.

Please verify account information for accuracy and legibility to avoid a delay in deposit.

ITEM 3. SIGNATURE

The person(s) requesting payment of the bonds must sign the form in ink, print his or her name, and provide his or her address, daytime telephone number, and if applicable, e-mail address. If the name of a person requesting payment has been changed by marriage or in any other legal manner from the name in the inscription of the bonds, the signature to the request for payment must show both names and the manner in which the change was made; for example, "Miss Mary T. Jones now by marriage Mrs. Mary T. Smith.”

FS Form 1522

Department of the Treasury | Bureau of the Fiscal Service

3

CERTIFICATION – To find the current redemption value of savings bonds of Series EE, Series E, or Series I, or of savings notes, use the Savings Bond Calculator at TreasuryDirect.gov.

If the current redemption value of your bonds totals $1,000 or less, your signature need not be certified. Rather, when you sign the form, you may verify your identity by enclosing a current copy of your driver’s license, passport, state ID, or military ID.

If the current redemption value of your bonds totals more than $1,000, each person whose signature is required must appear before and establish identification to the satisfaction of a notary or authorized certifying officer. The signatures to the form must be signed in the presence of the notary or officer. The notary or certifying officer must affix the seal or stamp which is used when certifying requests for payment. Authorized certifying officers are available at financial institutions, including credit unions, in the United States. Examples of acceptable seals and stamps:

The seal or stamp of a notary

A financial institution’s official seal or stamp, including: Signature Guaranteed seal or stamp; Endorsement Guaranteed seal or stamp; Corporate seal or stamp (a corporate resolution isn’t required); or Issuing or paying agent seal or stamp (including name, location, and four-digit identification number or nine-digit routing number)

The seal or stamp of Treasury-recognized Signature Guarantee Programs or other Treasury-approved Medallion Programs

WHERE TO SEND – Unless otherwise instructed, send this form and the bonds, as well as any other appropriate forms, evidence, or identification records, to the address below. Legal evidence or documentation you submit cannot be returned.

Treasury Retail Securities Services, P.O. Box 9150, Minneapolis, MN 55480-9150

(Phone: 844-284-2676--toll free.)

NOTICE UNDER THE PRIVACY AND PAPERWORK REDUCTION ACTS

The collection of the information you are requested to provide on this form is authorized by 31 U.S.C. CH. 31 relating to the public debt of the United States. The furnishing of a Social Security Number, if requested, is also required by Section 6109 of the Internal Revenue Code (26 U.S.C. 6109).

The purpose of requesting the information is to enable the Bureau of the Fiscal Service and its agents to issue securities, process transactions, make payments, identify owners and their accounts, and provide reports to the Internal Revenue Service. Furnishing the information is voluntary; however, without the information, the Fiscal Service may be unable to process transactions.

Information concerning securities holdings and transactions is considered confidential under Treasury regulations (31 CFR, Part 323) and the Privacy Act. This information may be disclosed to a law enforcement agency for investigation purposes; courts and counsel for litigation purposes; others entitled to distribution or payment; agents and contractors to administer the public debt; agencies or entities for debt collection or to obtain current addresses for payment; agencies through approved computer matches; Congressional offices in response to an inquiry by the individual to whom the record pertains; as otherwise authorized by law or regulation.

We estimate it will take you about 15 minutes to complete this form. However, you are not required to provide information requested unless a valid OMB control number is displayed on the form. Any comments or suggestions regarding this form should be sent to the Bureau of the Fiscal Service, Forms Management Officer, Parkersburg, WV 26106-1328. DO NOT SEND completed form to the above

address; send to the address shown in "WHERE TO SEND" above.

FS Form 1522

Department of the Treasury | Bureau of the Fiscal Service

4

Document Attributes

Fact Name Description
Purpose The FS Form 1522 is used to request payment for United States Savings Bonds, Savings Notes, Retirement Plan Bonds, and Individual Retirement Bonds.
Eligibility This form can be completed by the owner, co-owner, surviving beneficiary, or legal representative of a deceased owner's estate.
Identification Requirement Payees must provide a Social Security Number or Employer Identification Number for direct deposit payments.
Signature Certification If the bond's redemption value exceeds $1,000, signatures must be certified in the presence of a notary or certifying officer.
Governing Law The form is governed by regulations under 31 U.S.C. CH. 31 and 26 U.S.C. 6109.

Fs1522: Usage Instruction

Completing the FS Form 1522 is a crucial step in requesting payment for your United States Savings and Retirement Securities. After filling out the form, you will need to submit it along with any required identification to ensure your request is processed efficiently. Follow these steps carefully to avoid any delays.

  1. Gather Required Information: Collect all necessary details about the bonds, including the names of the registered owners, issue dates, and serial numbers.
  2. Fill Out Section 1: In the "DESCRIPTION OF BONDS" section, write the names of the individuals listed on the bonds. Include the issue dates and serial numbers for each bond. If you need more space, attach a separate list or use FS Form 3500.
  3. Complete Section 2: In the "INSTRUCTIONS FOR DIRECT DEPOSIT PAYMENT" section, provide either your Social Security Number or Employer Identification Number. Include the name(s) on the account, the bank routing number, and the type of account (checking or savings).
  4. Provide Financial Institution Details: Fill in the name and phone number of your financial institution accurately to prevent any issues with the deposit.
  5. Sign the Form: Under "SIGNATURE," certify the accuracy of the information provided. If the total redemption value of your bonds exceeds $1,000, sign in front of a notary or certifying officer.
  6. Provide Personal Information: Print your name, address, daytime telephone number, and email address in the appropriate fields.
  7. Certification: If the bonds are valued at $1,000 or less, you can simply sign the form and include a copy of your ID. If over $1,000, ensure you sign in the presence of a notary.
  8. Submit the Form: Send the completed FS Form 1522 along with the bonds and any other required documents to the Treasury Retail Securities Services at the specified address.

Frequently Asked Questions

  1. What is FS Form 1522?

    FS Form 1522 is a special request form used to request payment for United States Savings Bonds, Savings Notes, Retirement Plan Bonds, and Individual Retirement Bonds. It allows individuals or authorized representatives to claim payment for these securities.

  2. Who can complete FS Form 1522?

    This form can be completed by various individuals, including:

    • The owner of the bonds
    • Co-owners
    • Surviving beneficiaries
    • Legal representatives of the estate of a deceased or incompetent owner
    • Other persons entitled to payment under the regulations governing United States Savings Bonds
  3. What information is required on the form?

    When filling out FS Form 1522, you will need to provide:

    • The names of the individuals currently registered on the securities
    • The issue dates and serial numbers of the bonds
    • The payee's Social Security Number or Employer Identification Number
    • Bank account information for direct deposit, including the routing number and type of account
    • Signature and personal details of the individual requesting payment
  4. Do I need to provide identification?

    If the total redemption value of your bonds is $1,000 or less, you can verify your identity by enclosing a current copy of an acceptable form of ID, such as a driver’s license or passport. For bonds worth more than $1,000, signatures must be certified in the presence of a notary or authorized certifying officer.

  5. What happens if my name has changed?

    If your name has changed due to marriage or another legal reason, you must indicate both your current and previous names on the form. For example, you might write, "Miss Mary T. Jones now by marriage Mrs. Mary T. Smith."

  6. Where do I send FS Form 1522?

    Unless instructed otherwise, you should send the completed form, along with the bonds and any necessary identification, to:

    Treasury Retail Securities Services
    P.O. Box 9150
    Minneapolis, MN 55480-9150
    (Phone: 844-284-2676)

  7. What should I do if I encounter issues while completing the form?

    If you experience difficulties or have questions about the form, it is advisable to contact the Bureau of the Fiscal Service directly. They can provide guidance and assistance to ensure that your request is processed smoothly.

  8. What are the consequences of providing false information?

    Providing false, fictitious, or fraudulent information on FS Form 1522 is a serious offense. Such actions may lead to prosecution under federal law. It is crucial to ensure that all information provided is accurate and truthful.

Common mistakes

Filling out the FS Form 1522 can be a straightforward process, but there are common mistakes that can lead to delays or complications. One frequent error is failing to provide complete and accurate information in the DESCRIPTION OF BONDS section. It is crucial to list the names of all individuals currently registered on the bonds, along with the correct issue dates and serial numbers. Omitting any of these details can result in processing issues.

Another common mistake occurs in the DIRECT DEPOSIT PAYMENT section. Many people forget to include either a Social Security Number or an Employer Identification Number. This information is essential for processing the payment. Additionally, providing incorrect bank routing numbers can lead to funds being deposited into the wrong account, causing unnecessary frustration.

In the SIGNATURE section, individuals often overlook the requirement to sign in the presence of a notary or certifying officer if the total redemption value of the bonds exceeds $1,000. Failing to do so can invalidate the request. Furthermore, if there has been a name change due to marriage or other reasons, it is important to indicate both names on the form. Neglecting to do this may lead to complications in verifying identity.

Some individuals also make the mistake of not including their current address or daytime telephone number. This information is vital for communication regarding the request. Without it, the processing office may have difficulty reaching out if there are any questions or issues with the application.

Lastly, a significant error occurs when individuals do not follow the certification instructions. If the bonds are valued at $1,000 or less, the signature does not need to be certified, but a valid ID must be enclosed. If the value exceeds $1,000, the signature must be certified by a notary. Ignoring these requirements can lead to delays in payment.

Being mindful of these common mistakes can help ensure that the FS Form 1522 is completed accurately and efficiently. Taking the time to double-check each section before submission can prevent unnecessary complications and facilitate a smoother process for receiving payments for U.S. Savings and Retirement Securities.

Documents used along the form

The FS Form 1522 is used to request payment for United States Savings and Retirement Securities. When completing this form, you may also need to submit additional documents to ensure a smooth processing of your request. Below are four commonly used forms and documents that often accompany the FS Form 1522.

  • FS Form 3500: This form is used when additional space is needed to list multiple securities. If the number of bonds exceeds the space provided in FS Form 1522, attaching FS Form 3500 allows you to detail each bond's issue date and serial number, ensuring all necessary information is included.
  • Notarized Identification: If the total redemption value of the bonds exceeds $1,000, a notarized identification is required. This document serves as proof of identity and must be completed in the presence of a notary or certifying officer. It helps verify that the person requesting payment is indeed the rightful owner.
  • Direct Deposit Authorization: This document is essential if you wish to have your payment directly deposited into your bank account. It typically includes your bank account details, such as the routing number and account number, ensuring that funds are transferred accurately and promptly.
  • Proof of Identity Documents: When submitting the FS Form 1522, you may need to provide copies of identification, such as a driver’s license, passport, or military ID. These documents help establish your identity and confirm your entitlement to the securities.

By preparing these additional documents along with FS Form 1522, you can facilitate a more efficient processing of your request for payment. Ensuring that all necessary information is complete and accurate will help avoid delays and ensure a smoother experience.

Similar forms

  • FS Form 3500: Similar to FS Form 1522, FS Form 3500 is used to provide additional information about securities when the space on the primary form is insufficient. Both forms require details about the securities, such as issue dates and serial numbers, ensuring accurate identification for processing payments.
  • IRS Form W-9: This form requests the Taxpayer Identification Number (TIN) and certification from individuals or entities. Like FS Form 1522, it necessitates accurate personal information and signature verification to avoid issues with tax reporting and payments.
  • Form 1040: The individual income tax return form also requires personal identification information, including Social Security Numbers. Both forms serve to establish the identity of the individual for the purpose of processing payments or tax obligations.
  • Form 4506-T: This form allows taxpayers to request a transcript of their tax return. Similar to FS Form 1522, it requires a signature and personal identification information, ensuring that the request is legitimate and authorized by the individual.
  • Form SS-4: Used to apply for an Employer Identification Number (EIN), this form shares similarities with FS Form 1522 in that it collects essential identifying information about the applicant. Both forms emphasize the importance of accurate data for processing financial transactions.

Dos and Don'ts

When filling out the FS1522 form, consider the following dos and don'ts:

  • Do print clearly in ink or type all information.
  • Do provide accurate and complete information, including your Taxpayer Identification Number.
  • Do sign the form in the presence of a notary if the bond value exceeds $1,000.
  • Do include a current copy of an ID if the bond value is $1,000 or less.
  • Do verify your bank information to ensure accuracy for direct deposit.
  • Don't leave any required fields blank; incomplete forms may delay processing.
  • Don't provide false information; this can lead to legal consequences.
  • Don't forget to cross out item 2 if you are subject to backup withholding.
  • Don't submit the form without checking for errors or omissions.
  • Don't send the completed form to the wrong address; follow the instructions carefully.

Misconceptions

  • Misconception 1: The FS1522 form is only for individuals.
  • This form can be completed by various entities, including co-owners, surviving beneficiaries, or legal representatives of an estate. It is not limited to individuals alone.

  • Misconception 2: You do not need to provide a Taxpayer Identification Number.
  • Providing a Taxpayer Identification Number is mandatory. This helps ensure accurate processing of your payment request.

  • Misconception 3: Certification is always required for signatures.
  • If the current redemption value of the bonds is $1,000 or less, certification is not necessary. You can simply sign the form and include a copy of your ID.

  • Misconception 4: All signatures must be notarized regardless of the bond value.
  • Only signatures for bonds valued over $1,000 require notarization. For lower values, a simple signature and ID are sufficient.

  • Misconception 5: You can submit the form without verifying account information.
  • It is crucial to verify your account information for accuracy. Errors can delay the deposit process.

  • Misconception 6: The form can be submitted without any supporting documentation.
  • Along with the FS1522 form, you must include the bonds and any other necessary identification or documentation to support your request.

  • Misconception 7: The FS1522 form can be sent to any address.
  • This form must be sent to the specified address for Treasury Retail Securities Services. Sending it elsewhere may result in processing delays.

Key takeaways

When it comes to filling out and using the FS Form 1522, there are several key points to keep in mind. This form is essential for requesting payment of United States Savings and Retirement Securities. Here are some takeaways to guide you through the process:

  • Understand the Purpose: The FS Form 1522 is specifically designed to request payment for various types of U.S. savings bonds and retirement securities.
  • Who Can Use It: This form can be completed by the owner, co-owner, or legal representatives of the securities. Even a minor can fill it out if deemed competent by a notary.
  • Accurate Information is Key: Ensure that all information is printed clearly in ink or typed. Mistakes can lead to delays.
  • Provide Bond Details: Clearly list the names and serial numbers of the bonds for which you are requesting payment. This information is crucial for processing your request.
  • Direct Deposit Information: If you prefer direct deposit, you must provide your Social Security Number or Employer Identification Number, along with bank details such as routing and account numbers.
  • Signature Requirements: Your signature must be included, and if the bond's redemption value exceeds $1,000, you will need to sign in front of a notary.
  • Certification: If your bonds are worth $1,000 or less, you can simply include a form of identification instead of notarization.
  • Submission Guidelines: Send the completed form and any required documents to the specified address for processing. Keep in mind that submitted documents cannot be returned.
  • Privacy Matters: The information you provide is confidential and used solely for processing your request. Be aware of your rights regarding privacy and data protection.

By keeping these key points in mind, you can ensure a smoother experience when filling out and submitting the FS Form 1522. Always double-check your information and follow the instructions closely to avoid any complications.