PS Form 6401 – Fill Out and Use This PDF

Certification and Signature

I understand that anyone who furnishes false or misleading information on this form may be subject to criminal sanctions (including fines and imprisonment) and/or civil sanctions (including multiple damages and civil penalties). I agree to repay the Postal Service™, upon demand, the amount of the refund if the designated payee, purchaser, or financial institution cashes the original money order. The rights and remedies set forth in 18 U.S.C. 287, 18 U.S.C. 1001, and 31 U.S.C. 3802 shall be incorporated as if fully set forth.

Privacy Act Statement: Your information will be used to respond to your request. Collection is authorized by 39 U.S.C. 401, 403, and 404; 31 U.S.C. 5318, 5325, and 5331. Providing the information is voluntary, but if not provided, we may not process your transaction. We do not disclose your information to third parties without your consent, except to facilitate the transaction, to act on your behalf or request, or as legally required. This includes the following limited circumstances: to a congressional office on your behalf; to financial entities regarding financial transaction issues; to a U.S. Postal Service auditor; to entities, including law enforcement, as required by law including anti-money laundering statutes and regulations, or in legal proceedings; and to contractors and other entities aiding us to fulfill the service (service providers). For more information regarding our privacy policy visit us at usps.com.

After you file an inquiry, you can check the status by calling our toll-free number 1-866-974-2733.

SECTION B — THIS AREA IS FOR OFFICIAL USE ONLY

By presence of this signature, I have verified the customer receipt presented by the purchaser.

PS Form 6401, August 2016 PSN: 7530-02-000-9536 (Page 1 of 2)

Instructions for Completing Money Order Inquiry Form

Customer Action:

1.Complete Section A of the form in BLACK ink. Include the date of the original money order in boxes provided. Use ONE form per money order. Boxes titled Bank Use Only and Bank or Post Office Use Only are not required for individual customers. The telephone number fields are optional.

2.Sign the form and enter the date in the box titled Date Signed.

3.Show your money order customer receipt and personal identification to the sales and service associate at the service window.

Postal Service Employee Action:

1.Request the money order customer receipt and check the serial number, date, Post Office number, and amount against the information on the form. Return the money order customer receipt to the customer.

2.Collect the appropriate fee for the money order inquiry and place a meter strip or stamps in the outlined box.

3.In Section B: Enter the customer identification information (acceptable forms of identification are driver’s license, state issued ID, military

ID, alien registration card, or passport). Enter the following information for the office accepting the PS Form 6401 inquiry form: 10-digit finance number, telephone number, Post Office issue ID, signature of postal employee and date inquiry accepted.

4.If you have elected to issue a no-fee money order to the customer for a damaged or mutilated money order, complete office ZIP Code, serial number, date of issue, and dollar amount from the no-fee money order in Section B. Do not charge an inquiry fee for a no-fee money order. Write “FEE WAIVED” in the area designated for stamps or meter strip.

5.Sign and date the bottom of the form.

6.Place the original form in an envelope addressed to the St. Louis Accounting Center (address located on front of this form) and mail the same day. Do NOT retain.

Instructions for Completing Money Order Inquiry Submitted by Banks

Bank Action:

1.Complete Section A of the form in BLACK ink. (You must include your business/organization name and address. Use ONE form per money order.)

2.The ABA number is required for bank inquiries.

3.Sign the form.

4.Enter the date signed in the boxes provided.

Postal Service Employee Action for Bank Inquiries:

1.Customer photo ID, government issue ID, and customer receipt are not required for bank requests.

2.Include the 10-digit finance number, ZIP Code, and telephone number of the office accepting the Money Order Inquiry form.

3.Do not require a fee, this service is provided free of charge.

4.Do not issue a no-fee money order to a bank.

5.Put the original form in an envelope addressed to the St. Louis Accounting Center (address located on front of this form) and mail the same day. Do NOT retain.

Instructions for Completing Internal Money Order Inquiry Submitted by U.S. Postal Service

Postal Service Employee Action:

1.Complete Section A of the form in BLACK ink. You must include USPS organization name on line titled Bank Use or Post Office Use Only (Bank/Financial Institution Name or Post Office), address and date from the original receipt. Use ONE form per money order.

2.Sign and date the form.

3.Customer ID, government issue ID, and customer receipt are not required for internal requests.

4.Include the 10-digit finance number (the 10-digit number is your finance number and your 4-digit unit ID), ZIP Code, and telephone number of the office completing the Money Order Inquiry form (only if a no-fee money order is issued).

5.No fee is required for internal requests.

6.Enter Post Office Issue ID (this is the ZIP Code plus one digit to signify main office or branch).

7.Sign and date the bottom of the form.

8.Put the original form in an envelope addressed to the St. Louis Accounting Center (address located on front of this form) and mail the same day. Do NOT retain.

9.A scanned image will be provided to your facility if the money order has been cashed.

PS Form 6401, August 2016 (Page 2 of 2)