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GN 02402.075: Completion of the Direct Deposit Sign-Up Standard Form (SF) 1199A

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  • Effective Dates: 12/20/2006 - Present
  • Effective Dates: 04/03/2018 - Present
  • TN 29 (12-06)
  • TN 98 (04-18)
  • GN 02402.075 Completion of the SF-1199A
  • GN 02402.075 Completion of the Direct Deposit Sign-Up Standard Form (SF) 1199A
  • A. Process
  • A. When to accept the SF-1199A
  • Most direct deposit actions are taken without a form SF 1199A. However, forms may still be received in the FO for processing when a Financial Institution (FI) is the point of first contact with the claimant, or when the FO refers the claimant to the FI in those situations where the form is required. (See GN 02402.070B for situations where a completed, signed form is required.)
  • We only accept the SF-1199A for specific situations mentioned in GN 02402.070B.
  • A separate form must be completed for each FI account and/or each type of benefit.
  • If you receive an SF-1199A in the FO for any reason other than listed in GN 02402.070, follow the instructions to release an “Elimination of Domestic Direct Deposit SF-1199A Notification” per GN 02402.025B.
  • In postentitlement situations completed forms are retained in the FO for 3 months after processing, then destroyed. If a form is received with a claim, the electronic folder should be updated with the direct deposit information, receipted on the DW01 and then destroyed.
  • Retain completed forms for 3 months before destroying.
  • B. Description of Entries
  • In situations that require the SF-1199A, take the following steps:
  • * For initial claims, accept the SF-1199A to establish direct deposit. Receipt the direct deposit issue on the Development Worksheet (DW01), and then destroy the form.
  • * For postentitlement cases, retain completed forms for 3 months after processing and then destroy.
  • The SF 1199A is displayed in http://www.ssa.gov/deposit/1199a.pdf .
  • NOTE: Complete a separate form for each financial institution (FI) account and each type of benefit.
  • B. Description of SF-1199A entries
  • In this section, we describe the entries on form SF-1199A. Access the form at the following link https://www.gsa.gov/portal/forms/download/115702.
  • 1. Section 1
  • a. Block A -- Name of Payee
  • a. Block A - Name of Payee
  • Print the name of:
  • * The claimant (if capable), or
  • * The representative payee (if the claimant is not capable).
  • Print the name of the claimant (if capable) or representative payee (if the claimant is a minor child or not capable).
  • b. Block B - Name of Person Entitled to Payment
  • Print the name of the claimant included in the request.
  • c. Block C -- Claim or Payroll ID Name
  • c. Block C - Claim or Payroll ID Name
  • Print the SSN and Beneficiary Identification Code (BIC) or Individual Recipient Identification (ID) of the claimant.
  • Print the claimant’s SSN and Beneficiary Identification Code (BIC) or Individual Recipient Identification (ID).
  • d. Block D -- Type of Account
  • d. Block D - Type of Account
  • Place a checkmark in the appropriate box for a checking or savings account.
  • Check the appropriate box for checking or savings account.
  • e. Block E -- Depositor Account Number (DAN)
  • e. Block E - Depositor Account Number (DAN)
  • Print the DAN (see GN 02402.035).
  • Print the DAN per GN 02402.035.
  • f. Block F -- Type of Payment
  • f. Block F - Type of Payment
  • Indicate Social Security or Supplemental Security Income, as appropriate.
  • g. Block G -- Allotment Information
  • g. Block G - Allotment Information
  • This block should not be completed, since SSA will only approve direct deposit of the full payment amount.
  • Do not complete this block, since SSA only approves direct deposit for the full payment amount.
  • h. Signature Block -- Payee/Joint Payee Certification
  • h. Signature Block - Payee/Joint Payee Certification
  • This block must contain the signature of:
  • * The claimant, or
  • * The representative payee
  • This block must contain the claimant or representative payee’s signatures.
  • i. Optional Signature Block -- Joint Account Holder's Certification
  • i. Optional Signature Block - Joint Account Holder's Certification
  • This block will usually not be completed. If it shows a signature of a person not shown in the depositor account title, check the accuracy of the account title.
  • This block is usually not completed. If it shows a signature of a person not shown in the depositor account title, check the accuracy of the account title.
  • 2. Section 2
  • Ensure that the SF-1199A was completed for Social Security or Supplemental Security Income benefits.
  • A complete SF-1199A is required for Social Security or Supplemental Security Income benefits.
  • 3. Section 3
  • a. Name and Address of Financial Institution
  • Print the name and address of the FI.
  • b. Routing Number (RTN)
  • Print the RTN and appropriate check digit (see GN 02402.035).
  • Print the RTN and appropriate check digit per GN 02402.035.
  • c. Depositor Account Title
  • Print the exact title of the account (see GN 02402.050 for acceptable account titles).
  • Print the exact title of the account per GN 02402.050.
  • d. Financial Institution Certification
  • This block should be completed and signed by a representative of the FI.
  • A representative of the FI should complete and sign this block.
The materials available at this web site are provided free of charge, for informational purposes only, and without warrant by True Link Financial, Inc., and are not legal advice or Social Security benefits advice. You should contact your attorney to obtain advice with respect to any particular issue or problem, or the Social Security Administration with any general inquiries. Click here to view this section of the POMS on the Social Security Administration website.