TN 15 (08-05)

A. Policy - Receipt Book Log

The Remittance Supervisor must keep a log of any receipt books given to interviewers for out-of-office receipting activities or during periods of emergency; e.g., when the automated system is inoperative.

B. Exhibit - Receipt Book Log

The log should be locally reproduced as required. By signing, the interviewer concurs with the statement of certification.

RECEIPT BOOK LOG

I hereby acknowledge receipt of book of Forms SSA-1395-BK bearing serial numbers shown below next to my signature. I certify that all receipts listed below are contained in the book and that I understand the instructions for the issuance and safekeeping of Form SSA-1395-BK.

C. Procedure - Receipt Book Log

Follow the steps below to complete the Receipt Book Log each time the SSA-1395-BK Receipt Book is either issued or returned.

IMPORTANT: The Remittance Supervisor is responsible for completing all entries on the log with the exception of REP SIGNATURE block and REP INITIALS block.

The Remittance Supervisor retains the log with SSA-3944, Master Control Roster. See GN 02403.095.

Complete the Receipt Book Log as follows:

1. Date Book Issued

Enter date book is given to the interviewer.

2. Receipt Book Numbers

Enter first and last serial numbers of unissued receipts contained in the SSA-1395-BK receipt book.

3. REP Signature

Sign name (person receiving the book) upon receipt of the book from the Remittance Supervisor.

4. Date Book Returned

Enter date book is returned from the interviewer.

5. Receipt Numbers Used

Enter the number(s) of the receipt(s) which were used by the interviewer.

6. REP Initials

Sign initials (person receiving the book) indicating agreement with the log entries.

7. Issuer Signature

Sign your name to acknowledge receipt of the book back from the representative.

D. References

• GN 02403.008, Processing Remittances Received Outside the FO

• GN 02403.100, Issuing and Reassigning SSA-1395-BK Receipt Books

• GN 02403.100D., Reassigning SSA 1395-BK Receipt Books