Form Dd 2660 – Fill Out and Use This PDF

The DD Form 2660 is primarily utilized by individuals who are entitled to receive U.S. Treasury checks but have encountered issues such as loss, theft, destruction, or mutilation of their original checks, or those checks have been canceled due to limited payability. This form serves as a request for the issuance of a replacement check, guiding claimants through providing necessary information which will assist Disbursing Offices in both the determination and issuance processes. For those in need of securing a replacement check, taking prompt action by accurately completing and submitting this form is crucial.

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Form Dd 2660 PDF Details

In navigating the intricate workings of financial management within government sectors, the DD Form 2660 emerges as a pivotal tool, offering a streamlined process for claiming the reissuance of U.S. Treasury checks that have been lost, stolen, destroyed, or mutilated, or checks that could not be processed due to limited payability. Authorized under a combination of federal statutes and executive orders, this form stands as a testament to the meticulous record-keeping and procedural integrity required in managing public funds. Designed for use by individuals who are meant to receive payments from the government, it gathers essential information to ensure the proper cancellation of the original check and the issuance of a replacement, while also preventing fraudulent claims. The form's instructions underscore the importance of accuracy in the provided details, ranging from the claimant's contact information and the intended purpose of the check to the specifics of the check's issuance and the circumstances surrounding its non-receipt or damage. Alongside, it emphasizes the voluntary nature of disclosure, yet candidly advises on the repercussions of non-compliance, which may impede the process of obtaining a replacement check. Furthermore, it encapsulates a significant warning against the perpetration of fraudulent claims, reflecting the strict legal frameworks governing financial transactions with the government. Through the intricate dance of details necessitated by the DD Form 2660, the overarching principles of accountability, transparency, and efficiency in public financial administration are vividly highlighted.

Question	Answer
Form Name	Form Dd 2660
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	dd form 2660, dd 2660, dd2660 fillable, dd2660 form

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STATEMENT OF CLAIMANT REQUESTING REPLACEMENT CHECK	OMB No. 0730-0002
STATEMENT OF CLAIMANT REQUESTING REPLACEMENT CHECK	OMB approval expires
	Mar 31, 2017

The public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services, Executive Services Directorate, Directives Division, 4800 Mark Center Drive, Alexandria, VA 22350-3100 (0730-0002). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ORGANIZATION. RETURN IT TO THE ADDRESS OF THE AGENCY WHO PROVIDED THIS FORM.

PRIVACY ACT STATEMENT

AUTHORITY: 5 U.S.C. 301, Departmental Regulations; Department of Defense Financial Management Regulation (DoDFMR) 7000.14-R, Volume 5; 31 U.S.C. Sections 3511, 3512, and 3513; and E.O. 9397 (SSN) (as amended).

PRINCIPAL PURPOSE(S): To be used by intended recipients of U.S. Treasury checks to request a replacement for a lost, stolen, destroyed, or mutilated check, or one canceled due to limited payability. Disbursing Offices will use the information to make the determination to issue a replacement check based on the information provided, and for canceling the original check. The information will also verify a proper mailing address for the claimant. Applicable SORN: T7901 (http://dpcld.defense.gov/privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/6287/t7901.aspx).

STANFINS PIA (http://www.dfas.mil/foia/privacyimpactassessments.html).

ROUTINE USE(S): In addition to those disclosures generally permitted under 5 U.S.C. Section 552a of the Privacy Act, as amended, this information may be disclosed to the Department of Justice of U.S. Treasury for law enforcement purposes. It may also be disclosed for any of the "Blanket Routine Uses" as published in the Federal Register at the beginning of the DoD compilation of PA system notices. (http://dpcld.defense.gov/privacy/SORNs/component/dfas/preamble.html)

DISCLOSURE: Disclosure is voluntary; however, failure to disclose the requested data may prevent issuance of a replacement check. The Social Security Number is requested to verify the claimant and certify what happened to the original check issued by the government.

WARNING: Title 18, Sec 287, US Code: "Whoever makes or presents to any person or officer in the civil, military, or naval service of the United States, or to any department or agency thereof, any claim upon or against the United States, or any department or agency thereof, knowing such claim to be false, fictitious, or fraudulent, shall be imprisoned not more than five years and shall be subject to a fine in the amount provided in this title."

1.PAYEE (Show business name or financial organization, if applicable)

2. SSN/EIN

3.	TELEPHONE NUMBER (Include area code)	4. E-MAIL ADDRESS

5.	ACCOUNT TO BE CREDITED IF ITEM 1 IS A	FINANCIAL ORGANIZATION

6.	ADDRESS TO WHICH CHECK WAS MAILED (Include 9-digit ZIP Code)		7. CORRECT MAILING ADDRESS (If different from Item 6)

8. PURPOSE FOR WHICH CHECK WAS ISSUED (X as applicable)

d. OTHER

9. DATE DUE (Approximate)

a. REGULAR PAY

b. TRAVEL PAY

c. VENDOR PAY

(Specify)

10. CHECK WAS: (X as applicable)

11. WAS CHECK

a. NOT RECEIVED

b. RECEIVED,

(1) LOST

(3) DESTROYED

(5) CANCELED (LIMITED

ENDORSED? (X one)

PAYABILITY)

BUT:

(2) STOLEN

(4) MUTILATED

a. YES

b. NO

CERTIFICATION

I certify that I (we) have in no way benefitted from the proceeds of the above check, and do hereby request a replacement check be issued to me. I further certify that if I recover the original check, I will not negotiate it but will immediately return it to the Disbursing Office. I fully understand that negotiation of both the original and replacement check constitutes a fraudulent act against the United States Government and as such is subject to punishment as provided by law. I further consent to immediate recoupment from future pay and allowances due me if I negotiate both the original and replacement checks, including interest and administrative costs.

12.SIGNATURE OF PAYEE (Or payee representative)

13. DATE

14. SIGNATURE OF CO-PAYEE (If applicable)

15. DATE

FOR DISBURSING OFFICE USE

16. CHECK DATA

a. CHECK NUMBER

17. DO REMARKS

b. DATE OF CHECK

c. CHECK AMOUNT

d. ISSUING DSSN

e. VOUCHER NUMBER

DD FORM 2660, AUG 2015

PREVIOUS EDITION IS OBSOLETE.

Adobe Professional X

INSTRUCTIONS FOR COMPLETING STATEMENT OF CLAIMANT REQUESTING REPLACEMENT CHECK

1.	PAYEE	Payee name, business name or financial organization.

2.	PAYEE’S SSN/EIN	Payee’s SSN (for individual) or EIN (for business).

3.	TELEPHONE NUMBER	Payee Telephone Number.

4.	E-MAIL ADDRESS	Payee e-mail address.

5.	ACCOUNT TO BE	Enter account number to have been credited.
	CREDITED IF ITEM 1 IS A
	FINANCIAL
	ORGANIZATION

6.	ADDRESS TO WHICH	Address on file.
	CHECK WAS MAILED

7.	CORRECT MAILING	New Address.
	ADDRESS

8.	PURPOSE FOR WHICH		a. REGULAR PAY
	CHECK WAS ISSUED		b. TRAVEL PAY
			c. VENDOR PAY
			d. OTHER (specify what type of pay)

9.	DUE DATE	Date check was due to arrive.

10. CHECK WAS:		X as applicable:
			a. NOT RECEIVED
			b. RECEIVED BUT:
			(1) LOST
			(2) STOLEN
			(3) DESTROYED
			(4) MUTILATED
			(5) CANCELED (LIMITED PAYABILITY)

11. WAS CHECK ENDORSED?		Answer Yes or No.

12.SIGNATURE OF PAYEE Signature of the Payee or payee representative.

13.	DATE		Self Explanatory

14.	SIGNATURE OF CO-PAYEE		Signature of Co-Payee (if applicable).

15. DATE			Self Explanatory.

16. CHECK DATA			For Disbursing Office Use.
	16a.	CHECK NUMBER
	16b. DATE OF CHECK
	16c.	CHECK AMOUNT
	16d. ISSUING DSSN
	16e.	VOUCHER NUMBER

17.DO REMARKS

DDFORM 2660 (BACK), AUG 2015

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Form Dd 2660 – Fill Out and Use This PDF

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