Note Report Form – Fill Out and Use This PDF

Note Report Forms are an essential tool for widespread businesses, allowing staff to effectively store, organize and manage highly sensitive information. This easily accessible form allows the collection of important data to track progress and results in areas of innovation, reviews, communication and customer service. Note Report forms help you stay aware of notable changes in processes or activities over long periods of time while also enabling smooth execution of workflow between team members, departments or projects. Aiming to create transparency throughout all functions of the business, this growing mode keeps every authority level in line with current interests as well as established trends across the related field for successful decision making.

Note Report Form PDF Details

Do you want to make it easier for your team to report and keep track of their notes? With the right tools, it is easy to streamline this task in an efficient and comprehensive way. Not only can reports be shared quickly between coworkers, but they can also be stored securely for future reference. Using a note report form allows users to improve collaboration within their organization by capturing important information quickly and easily. Read on to learn how note report forms work and why they are an essential part of any successful workflow!

Question	Answer
Form Name	Note Report Form
Form Length	1 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	15 sec
Other names	us secret service counterfeit bill, counterfeit note report, us secret service counterfeit form, secret service counterfeit bill form

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DEPARTMENT OF HOMELAND SECURITY

United States Secret Service

COUNTERFEIT NOTE REPORT

INSTRUCTIONS TO BANK:

1.Prepare and submit one copy of this completed form with each suspected counterfeit note to your local SECRET SERVICE OFFICE.

2.If desired, an additional copy of this form should be prepared and retained for your records.

3.Unless advised otherwise, the suspect note submitted to the Secret Service should be considered counterfeit.

4.The Secret Service WILL NOT return a copy of this form.

NAME OF BANK:

BANK ROUTING NUMBER:

POINT-OF-CONTACT:

POINT-OF-CONTACT'S E-MAIL: (if different from above)

POINT-OF-CONTACT'S TELEPHONE NUMBER: (include area code)

POINT-OF-CONTACT'S FAX NUMBER: (include area code)

MAILING ADDRESS OF BANK: (include ZIP Code)

DO NOT WRITE IN THIS SPACE

Classification Number

IMPORTANT NOTICE

Bank tellers and persons surrendering the note should date and initial each counterfeit note one time with pen and ink in the border area of the note for identification. If the person surrendering the note knows from whom he/she received it, or has a description of the passer, or his/her auto, or any other information, TELEPHONE the local police department or Secret Service office IMMEDIATELY and hold the note. (The telephone number of the nearest Secret Service office may be found at www.secretservice.gov.) Otherwise, if no information is available, please mail the note to the Secret Service local office on the day it is received. The submitting bank agrees to abandon any property interest in counterfeit notes it surrenders to the Secret Service.

DESCRIPTION OF COUNTERFEIT NOTE OR RAISED NOTE (for raised note give serial number only)

DENOMINATION

FEDERAL RESERVE BANK (Series 1996 - Letter/Number)

NOTE POSITION LETTER/NOTE POSITION NUMBER

NOTE POSITION LETTER/FACE PLATE NO.

BACK PLATE NO.

SERIES

SERIAL NUMBER

COUNTERFEIT NOTE RECEIVED FROM

NAME OF INDIVIDUAL / BUSINESS

DATE OF ACTIVITY OR DEPOSIT

HOME ADDRESS (OR BUSINESS LOCATION WHERE COUNTERFEIT WAS PASSED)

HOME PHONE (with Area Code)

BUSINESS PHONE (with Area Code)

NAME OF PERSON SURRENDERING AND INITIALING NOTE

NAME OF TELLER RECEIVING AND INITIALING NOTE

INFORMATION ABOUT COUNTERFEIT NOTE

DOES THE CUSTOMER HAVE ANY INFORMATION AS TO THE SOURCE OF THE COUNTERFEIT?	Yes	No
WAS THERE ANY SUSPICIOUS ACTIVITY?	Yes	No
WAS THERE ANY SUSPICIOUS ACTIVITY?	Yes	No
IS THIS A NON - CUSTOMER?	Yes	No
IS THIS A NON - CUSTOMER?	Yes	No

REMARKS:

DISPOSITION (For Secret Service Use Only)

Genuine note and SSF 1604 returned to bank (Receipt No.

)

This form is not subject to the requirements of Pub. L. 96-511 ''Paperwork Reduction Act of 1980." 44 U.S.C., Chapter 35, Section 3518 (c)(1)(A) states that, "...this chapter [Chapter 35] does not apply to the collection of information ... during the conduct of a Federal criminal investigation..."

PLEASE SUBMIT TO THE LOCAL SECRET SERVICE JURISDICTIONAL FIELD OFFICE

SSF 1604 (Rev. 09/2015)	Page 1 of 1

How to Edit Note Report Form Online for Free

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This PDF form will require you to provide specific information; to guarantee correctness, please make sure to consider the next recommendations:

1. For starters, when filling in the counterfeit note report pdf, begin with the area that features the following blank fields:

Completing section 1 in counterfeit report

2. The subsequent part would be to submit all of the following blanks: COUNTERFEIT NOTE RECEIVED FROM, NAME OF INDIVIDUAL BUSINESS, DATE OF ACTIVITY OR DEPOSIT, HOME ADDRESS OR BUSINESS LOCATION, HOME PHONE with Area Code, BUSINESS PHONE with Area Code, NAME OF PERSON SURRENDERING AND, NAME OF TELLER RECEIVING AND, INFORMATION ABOUT COUNTERFEIT NOTE, DOES THE CUSTOMER HAVE ANY, WAS THERE ANY SUSPICIOUS ACTIVITY, IS THIS A NON CUSTOMER, REMARKS, Yes, and Yes.

Guidelines on how to prepare counterfeit report step 2

Many people generally get some points wrong when completing DOES THE CUSTOMER HAVE ANY in this section. Ensure that you go over whatever you enter here.

3. The following section is about Genuine note and SSF returned to, This form is not subject to the, SSF Rev, PLEASE SUBMIT TO THE LOCAL SECRET, and Page of - type in each one of these fields.

counterfeit report conclusion process outlined (part 3)

Step 3: Once you have looked once again at the details you given, click "Done" to conclude your FormsPal process. Join us today and easily access counterfeit note report pdf, available for download. All alterations made by you are saved , making it possible to modify the pdf at a later time if required. Here at FormsPal.com, we do our utmost to make sure your information is stored protected.

Note Report Form – Fill Out and Use This PDF

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