Check Services Forms

Use the links below to access the forms and agreements you will need to set up or use Federal Reserve Financial Services.

Service and Access Setup provides more details and guidance on the steps required to begin using a new service or to modify current services or access.

If you are unable to locate the form you seek, My FedDirectorySM provides a comprehensive list of service and support contacts who can assist you.

Check 21-Enabled Services Agreements

The agreements below must be completed and signed by an authorized individual listed on the institution’s Official Authorization List (OAL) on file at the Federal Reserve Bank.

If a financial institution has updates to an existing agreement, only applicable portions should be completed and signed. Agreements must be returned to:

E-mail: C21.Agreements@atl.frb.org

Fax:
404-498-8294

Mail:
Federal Reserve of Atlanta
Attn: Check 21 Customer Support
1000 Peachtree Street NE, 3rd floor
Atlanta, GA 30309-4470
FedForward Cull Service Agreement
Completion of this form is required before a financial institution may send electronic items to a Federal Reserve Bank, receive electronic items from a Federal Reserve Bank, or send to a Reserve Bank physical items that are designated for processing under Appendix G of Federal Reserve Bank Operating Circular 3 (collectively, “Items”). The Federal Reserve Bank uses this form to obtain information that is needed to successfully complete “Check 21” product enrollment and set-up processes. 		Form (PDF)
Check 21 Services Agreement and Set Up Form (v 5.8)
 Completion of this form is required before a financial institution may send electronic items to a Federal Reserve Bank, receive electronic items from a Federal Reserve Bank, or send to a Reserve Bank physical items that are designated for processing under Appendix G of Federal Reserve Bank Operating Circular 3 (collectively, “Items”). The Federal Reserve Bank uses this form to obtain information that is needed to successfully complete “Check 21” product enrollment and set-up processes.		 Form (PDF)
Check 21 Agency Agreement (v 2.0)
This agreement appoints an agent for accessing Federal Reserve Bank Check Collection and Return Services.		 Form (PDF)
Electronic Check Presentment and Image Information Service
This Agreement sets forth the terms of our Electronic Check Presentment and Image Information Service. 		Form (PDF)
Check Presentment and Return Agreement
This Agreement sets forth the terms of our PDF Check Presentment and Return service.
 Form (PDF)

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Check Adjustment Services
The following electronic forms are available to support processing of all check adjustment requests. For more information on the required forms, visit the Check Adjustments Quick Reference Guide
Check Adjustment Request Form Form (PDF)
Check 21 Warranty/Indemnity Claim Form Form (PDF)
Claim of Late Return Form (PDF)
Claim of Damage Due to an Underencoding Form (PDF)
Document-to-Follow (DTF) Fax Cover Sheet Form (PDF)
Duplicate Check/Image Adjustment Certification Form Form (PDF)
Expedited Recredit Claim Form Form (PDF)
Paying Bank's Response to a Claim of Late Return Form (PDF)

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Cash Letter Forms
Standardized cash letter forms are offered for your use when sending cash letters to your local Federal Reserve Bank. These forms will open in Microsoft Excel and include drop down lists with selections to help you fill out the form.

Please note: In order for these forms to function properly, macros within the Excel worksheets must be enabled. Upon opening one of the below forms, if you see an Excel Security Warning across the top of your toolbar stating that your macros have been disabled, you may need to enable the macro content that allows the form to populate correctly.

However, if you are using an older version of Excel, you may receive a warning message advising the form contains macros. To make the most effective use of the features in these forms, read the message and enable the macro if you agree. Disabling the macros will remove the interactivity from the forms and may cause them not to load properly.
Canadian Check Form (XLS)
Instructions (Off-site Link)
Foreign Check Form (XLS)
Instructions (Off-site Link)
Check 21 FedForward Form (XLS)
Instructions (Off-site Link)
Forward Item Form (XLS)
Instructions (Off-site Link)
Forward Not Our Item Form (XLS)
Instructions (Off-site Link)
Government Deposit Form (XLS)
Instructions (Off-site Link)
Image Only - Non Deposit Form (XLS)
Instructions (Off-site Link)
Large Dollar Return Form (XLS)
Instructions (Off-site Link)
Postal Money Order Form (XLS)
Instructions (Off-site Link)
Return Item Form (XLS)
Instructions (Off-site Link)
Return Not Our Item Form (XLS)
Instructions (Off-site Link)

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Vendor Profile Form
Vendor Profile Form
Completion of the form allows the Federal Reserve Banks to notify vendors supporting our check services about announcements that affect software vendors. 		Form (DOC)

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Additional Check Service Agreements
Delivery Point- Physical Items Agreement Form (PDF)
Delivery Point- Adjustment Advices Agreement Form (PDF)
MICR, Truncation and Information Services Agreement Form (PDF)
FedImage Information Services Agreement Form (PDF)
Same Day Settlement (SDS) Services Agreement Form (PDF)
Explicit Float Availability Option Agreement Form (PDF)
Return Item Re-Clearing Service Agreement Form (PDF)
Service Discontinuation Notice Form (PDF)
Canadian Check Processing Service Sign-Up Form
Please wait 10 days from submission of this form to deposit Canadian items.		 Form
Foreign Check Sign-Up Agreement
Please wait 10 days to begin depositing your foreign items. 		Form

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District Check Forms
2nd District
Federal Reserve Bank of New York
7th District
Federal Reserve Bank of Chicago
6th District
Federal Reserve Bank of Atlanta
11th District
Federal Reserve Bank of Dallas
12th District
Federal Reserve Bank of San Francisco

National Fine Sort Cash Letter Recap (PDF)

National Fine Sort Cash Letter Recap (Excel)

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