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 or need assistance in completing the agreements and/or forms below, My FedDirectory® provides a comprehensive list of service and support contacts that can assist you.

Check 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: ccc.bankservices@kc.frb.org

Fax:
877-281-3647

Mail:
Customer Contact Center
P.O. Box 219416
Kansas City, MO 64121-9416

Check 21 Services Agreement and Set Up Form (v 7.3)
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 4.0)
This agreement appoints an agent for accessing Federal Reserve Bank Check Collection and Return Services.
Form (PDF)
Check Presentment and Return Agreement
This agreement sets forth the terms of our PDF Check Presentment and Return Service.
Form (PDF)

Top of Page

Check Adjustments 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 Adjustments 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)
Expedited Recredit Claim Form Form (PDF)
Paying Bank's Response to a Claim of Late Return Form (PDF)

Top of Page

Cash Letter Forms
Standardized cash letter forms are offered for your use when sending cash letters to the Federal Reserve Bank of Atlanta at the address noted on the form. These forms will open in Microsoft® Excel® and can be completed when opened from the website, or saved to your computer for later use.
Regular Savings Bonds
The Regular Savings Bonds cash letter form should be used for all card style and half sheet bonds.
Form (PDF)
Full-Sheet Savings Bonds
The Full-Sheet Savings Bonds cash letter form should be used for older bonds that were issued on full-sheet certificates which, because of their age, are fairly rare.
Form (PDF)
Facsimile Savings Bonds
The Facsimile Savings Bonds cash letter form should only be used for properly prepared facsimiles (PDF) of bonds that were lost or destroyed in transit.
Form (PDF)

Canadian Check

Foreign Check

Form (XLS)
Instructions (PDF)

Forward Item

Forward Not Our Item Form (XLS)
Instructions (PDF)
Government Deposit Form (XLS)
Instructions (PDF)
Image Only - Non Deposit Form (XLS)
Instructions (PDF)
Postal Money Order Form (XLS)
Instructions (PDF)

Return Item

Return Not Our Item

Form (XLS)
Instructions (PDF)

Top of Page

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)

Top of Page

Additional Check Services Enrollment Forms
Canadian Check Processing Service Sign-Up Form Form
Foreign Check Sign-Up Agreement Form

Top of Page