ACH Instructions

Instructions for Completing SF 3881 Form

1. Agency information Section - Federal agency prints or types the name and address of the Federal program agency originating the vendor/miscellaneous payment, agency identifier, agency location code, contact person name and telephone number of the agency. Also, the appropriatebox for ACH format is checked.

2. Payee/Company Information Section - Payee prints or types the name of the payee/company and address that will receive ACH vendor/miscellaneous payments, social security or taxpayer ID number, and contact person name and telephone number of the payee/company. Payee also verifies depositor account number, account title, and type of account entered by your financial institution in the Financial Institution Information Section.

3. Financial Institution Information Section - Financial institution prints or types the name and address of the payee/company's financial institution who will receive the ACH payment, ACH coordinator name and telephone number, nine-digit routing transit number, depositor (payee/company) account title and account number. Also, the box for type of account is checked, and the signature, title, and telephone number of the appropriate financial institution official are included.

Burden Estimate Statement

The estimated average burden associated with this collection of information is 15 minutes per re-spondent or recordkeeper, depending on individual circumstances. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be directed to the Financial Management Service, Facilities Management Division, Property and Supply Branch, Room B-101, 3700 East-West Highway, Hyattsville, MD 20782 and the Office of Management and Budget, Paperwork Reduction Project (1510-0056), Washington, DC 20503.

Pointers for Completing SF 3881 Form

To answer some of questions that vendors and agencies have raised when completing the vendor enrollment form and prevent some of the mistakes that have occurred, the FMS is presenting these additional pointers.

1. The Federal agency initiates the SF 3881 form to enroll its vendors to receive payment by electronic funds transfer.

2. A vendor must complete a separate enrollment form (SF 3881) for each agency with which it does business.

3. In the Agency Information Section, the term AAGENCY IDENTIFIER@ means the acronym by which the agency is known. For example, the AAGENCY IDENTIFIER@ for the Financial Management Service is FMS.

4. In the Payee/Company Information Section, it should be noted that the ATAXPAYER ID NO.@ may be used by the Government to collect and report on any delinquent amounts arising out of the offerer=s relationship with the Government (31 U.S.C. 7701 (c) (3)).

5. The financial institution and the vendor should each keep a copy of the completed form.

6. The vendor should return the completed SF 3881 to the agency that initiated the form.

ACH VENDOR/MISCELLANEOUS PAYMENT

OMB No. 1510-0056

Expiration Date 06/30/93

ENROLLMENT FORM

This form is used for Automated Clearing House (ACH) payments with an addendum record that contains payment-related information processed through the Vendor Express Program. Recipients of these payments should bring this information to the attention of their financial institution when presenting this form for completion.

PRIVACY ACT STATEMENT

The following information is provided to comply with the Privacy Act of 1974 (P.L. 93-579). All infor-mation collected on this form is required under the provisions of 31 U.S.C. 3322 and 31 CFR 210. This information will be used by the Treasury Department to transmit payment data, by electronic means to vendor's financial institution. Failure to provide the requested information may delay or prevent the receipt of payments through the Automated Clearing House Payment System.

AGENCY INFORMATION
^{FEDERAL PROGRAM AGENCY USDA/FSA/FMD}
^{AGENCY IDENTIFIER FSA/CCC}	^{AGENCY LOCATION CODE (ALC): 00004992}	^{ACH FORMAT:} _X_CCD+_{_}_CTX
^{ADDRESS: 1400 Independence Avenue, S.W. STOP 0581 Washington, D.C. 20250-0581}

^{CONTACT PERSON NAME: Pamela Knot / David Erickson}	^{TELEPHONE NUMBER: (703) 305-1415/1420}
^{ADDITIONAL INFORMATION: CCC Washington Disbursement Office}

PAYEE/COMPANY INFORMATION
^NAME:	^{SSN NO. OR TAXPAYER ID NO.}
^ADDRESS:

^{CONTACT PERSON NAME:}	^{TELEPHONE NUMBER:}

FINANCIAL INSTITUTION INFORMATION
^NAME:
^ADDRESS:

^{ACH COORDINATOR NAME:}	^{TELEPHONE NUMBER:}
^{NINE-DIGIT ROUTING TRANSIT NUMBER:} _ _ _ _ _ _ _ _ _
^{DEPOSITOR ACCOUNT TITLE:}
^{DEPOSITOR ACCOUNT NUMBER:}		^{LOCKBOX NUMBER:}
^{TYPE OF ACCOUNT:}
_CHECKING	_SAVINGS	_LOCKBOX
^{SIGNATURE AND TITLE OF AUTHORIZED OFFICIAL:(Could be the same as ACH Coordinator)}		^{TELEPHONE NUMBER:}

^{NSN 7540-01-274-9925}

^3881-102

AGENCY COPY

^{SF 3881 (Rev 12/90)}

^{Prescribed
by Department of Treasury}

^{31
U S C 3322; 31 CFR 210}