How to Fill Out Standard Form 1199A
Standard Form 1199A is filled out by a government employee, retiree, or beneficiary and their bank representative.
1. Payee (person receiving federal payments) must provide the following in Section 1.
- Payee name, address, and phone number
- Claim or payroll ID number
- Bank account and details
- Account type and number
- Payment type
- Payment type, and if applicable, allotment
- Payee signature
2. The payee or the financial institution provides the government agency’s name and address.
3. Payee gives the form to their financial institution for a bank representative to enter in:
- Bank name and address
- Routing number
- Account title
- Bank representative name and signature