GSA Form SF-1198 Request by Employee for Allotment of Pay for Credit to Savings Account With a Financial Organization

GSA Form STANDARD1198 is a U.S. General Services Administration form also known as the "Request By Employee For Allotment Of Pay For Credit To Savings Account With A Financial Organization". The latest edition of the form was released in March 1, 1982 and is available for digital filing.

Download a PDF version of the GSA Form STANDARD1198 down below or find it on U.S. General Services Administration Forms website.

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(a) Complete one form for each savings account.
(e) Employee is to distribute copies as designated.
(b) Employee is to initiate this form.
INSTRUCTIONS
(c) Employee is to complete part A in triplicate.
(d) Financial organization is to complete part B in triplicate.
Standard Form 1198
REQUEST BY EMPLOYEE FOR ALLOTMENT OF PAY FOR CREDIT
(Rev. 3-82)
Department of the Treasury
TO SAVINGS ACCOUNT WITH A FINANCIAL ORGANIZATION
I TFM 3-9000
(1) Name of Employee (As stated on payroll)
(2) Social Security Number
(3) Home Address
(4) Agency (Include also Bureau, Division, Branch or other designation of employing organization)
TO BE
You are hereby authorized, in accordance with 31 CFR part 209, subject to all the conditions stated on this document, to take the action requested
below with respect to deductions from salaries or wages due me in the amount specified below which are for remittance to the financial organization
COMPLETED
designated below, for credit to my savings account. Action will be effective within the next two full pay periods and deductions will continue until
canceled by me in writing.
BY
(5) Action requested on Allotment ("X" one and fill in amount)
Initiate $
Increase from $
to $
EMPLOYEE
(A)
Cancel $
Decrease from $
to $
An authorization for a new or decreased allotment must be completed by the financial organization. An authorization to increase of cancel an
allotment should be submitted directly to the employing agency.
(6) Allotment to Be Sent To (name of financial organization)
(7) Signature of Employee
(8) Employee's Savings Account No. At
(9) Date Submitted to Agency
Financial Organization
(10)
We, the above-designated financial organization, hereby agree to act as agent of the above-named Government employee in the capacity
indicated and to accept as our expense, such service charge, at the rate established in regulations of the Department of the Treasury, as will be
deducted from the amount remitted to us. Our complete account number for the savings account to be credited is inserted in Block No. (8), so as
to be included on records accompanying remittances.
THE FINANCIAL ORGANIZATION WILL CHECK WHICHEVER OF THE FOLLOWING PROVISIONS IS APPLICABLE
The address in Block No. (12) is the single point in this financial organization which is to
TO BE
receive remittances for all allotments of pay of Government employees designating this
financial organization. Our "employer identification number" (same as the tax identification
COMPLETED
number assigned by Internal Revenue Service) is inserted in Block No. (11).
We can agree to act as agent of the above-named person in the capacity indicated only if
BY
remittances are forwarded to our respective branch office where the savings account is
maintained. The related branch office for this allotment of pay is identified by the
(11) Employee Identification No.
parenthetical suffix inserted with our "employer identification number" (same as the tax
FINANCIAL
identification number assigned by Internal Revenue Service) in Block No. (11) coordinate
with the address shown in Block No. (12).
ORGANIZATION
(12) Address of Financial Organization
(a) Street
(B)
(b) City
(c) State
(d) Zip Code
(13) Authorized Signature
(14) Title
(15) Date
Agency payroll offices and disbursing offices operate within rigid time schedule to assure timely delivery of checks for net pay on the established
ATTENTION
payday and there will be no change in this emphasis. As requested above, the amount allotted will be deducted from your salaries or wages and will be
remitted by the disturbing office, as soon as practicable, to the designated recipient. It should be understood that such remittance may be received by
EMPLOYEE
the recipient later than the regular payday--possibly 3 or 4 business days later.
AND
PRIVACY ACT STATEMENT 5 USC 5525 permits Federal agencies to collect this information. Executive Order 9397 allows Federal agencies to use
the Social Security number as an individual identifier to avoid confusion caused by employees with the same of similar names. the information
FINANCIAL
furnished on this form is confidential and is needed to provide entitlement to the benefits of the financial arrangement authorized by the authority cited.
The information will be used to process the payment data from the Government agency to the recipient. Failure to provide the information requested
ORGANIZATION
may affect the entitlement to such benefits.
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION USABLE
EMPLOYEE'S PAYROLL OFFICE
(a) Complete one form for each savings account.
(e) Employee is to distribute copies as designated.
(b) Employee is to initiate this form.
INSTRUCTIONS
(c) Employee is to complete part A in triplicate.
(d) Financial organization is to complete part B in triplicate.
Standard Form 1198
REQUEST BY EMPLOYEE FOR ALLOTMENT OF PAY FOR CREDIT
(Rev. 3-82)
Department of the Treasury
TO SAVINGS ACCOUNT WITH A FINANCIAL ORGANIZATION
I TFM 3-9000
(1) Name of Employee (As stated on payroll)
(2) Social Security Number
(3) Home Address
(4) Agency (Include also Bureau, Division, Branch or other designation of employing organization)
TO BE
You are hereby authorized, in accordance with 31 CFR part 209, subject to all the conditions stated on this document, to take the action requested
below with respect to deductions from salaries or wages due me in the amount specified below which are for remittance to the financial organization
COMPLETED
designated below, for credit to my savings account. Action will be effective within the next two full pay periods and deductions will continue until
canceled by me in writing.
BY
(5) Action requested on Allotment ("X" one and fill in amount)
Initiate $
Increase from $
to $
EMPLOYEE
(A)
Cancel $
Decrease from $
to $
An authorization for a new or decreased allotment must be completed by the financial organization. An authorization to increase of cancel an
allotment should be submitted directly to the employing agency.
(6) Allotment to Be Sent To (name of financial organization)
(7) Signature of Employee
(8) Employee's Savings Account No. At
(9) Date Submitted to Agency
Financial Organization
(10)
We, the above-designated financial organization, hereby agree to act as agent of the above-named Government employee in the capacity
indicated and to accept as our expense, such service charge, at the rate established in regulations of the Department of the Treasury, as will be
deducted from the amount remitted to us. Our complete account number for the savings account to be credited is inserted in Block No. (8), so as
to be included on records accompanying remittances.
THE FINANCIAL ORGANIZATION WILL CHECK WHICHEVER OF THE FOLLOWING PROVISIONS IS APPLICABLE
The address in Block No. (12) is the single point in this financial organization which is to
TO BE
receive remittances for all allotments of pay of Government employees designating this
financial organization. Our "employer identification number" (same as the tax identification
COMPLETED
number assigned by Internal Revenue Service) is inserted in Block No. (11).
We can agree to act as agent of the above-named person in the capacity indicated only if
BY
remittances are forwarded to our respective branch office where the savings account is
maintained. The related branch office for this allotment of pay is identified by the
(11) Employee Identification No.
parenthetical suffix inserted with our "employer identification number" (same as the tax
FINANCIAL
identification number assigned by Internal Revenue Service) in Block No. (11) coordinate
with the address shown in Block No. (12).
ORGANIZATION
(12) Address of Financial Organization
(a) Street
(B)
(b) City
(c) State
(d) Zip Code
(13) Authorized Signature
(14) Title
(15) Date
Agency payroll offices and disbursing offices operate within rigid time schedule to assure timely delivery of checks for net pay on the established
ATTENTION
payday and there will be no change in this emphasis. As requested above, the amount allotted will be deducted from your salaries or wages and will be
remitted by the disturbing office, as soon as practicable, to the designated recipient. It should be understood that such remittance may be received by
EMPLOYEE
the recipient later than the regular payday--possibly 3 or 4 business days later.
AND
PRIVACY ACT STATEMENT 5 USC 5525 permits Federal agencies to collect this information. Executive Order 9397 allows Federal agencies to use
the Social Security number as an individual identifier to avoid confusion caused by employees with the same of similar names. the information
FINANCIAL
furnished on this form is confidential and is needed to provide entitlement to the benefits of the financial arrangement authorized by the authority cited.
The information will be used to process the payment data from the Government agency to the recipient. Failure to provide the information requested
ORGANIZATION
may affect the entitlement to such benefits.
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION USABLE
EMPLOYEE'S PAYROLL OFFICE
(a) Complete one form for each savings account.
(e) Employee is to distribute copies as designated.
(b) Employee is to initiate this form.
INSTRUCTIONS
(c) Employee is to complete part A in triplicate.
(d) Financial organization is to complete part B in triplicate.
Standard Form 1198
REQUEST BY EMPLOYEE FOR ALLOTMENT OF PAY FOR CREDIT
(Rev. 3-82)
Department of the Treasury
TO SAVINGS ACCOUNT WITH A FINANCIAL ORGANIZATION
I TFM 3-9000
(1) Name of Employee (As stated on payroll)
(2) Social Security Number
(3) Home Address
(4) Agency (Include also Bureau, Division, Branch or other designation of employing organization)
TO BE
You are hereby authorized, in accordance with 31 CFR part 209, subject to all the conditions stated on this document, to take the action requested
below with respect to deductions from salaries or wages due me in the amount specified below which are for remittance to the financial organization
COMPLETED
designated below, for credit to my savings account. Action will be effective within the next two full pay periods and deductions will continue until
canceled by me in writing.
BY
(5) Action requested on Allotment ("X" one and fill in amount)
Initiate $
Increase from $
to $
EMPLOYEE
(A)
Cancel $
Decrease from $
to $
An authorization for a new or decreased allotment must be completed by the financial organization. An authorization to increase of cancel an
allotment should be submitted directly to the employing agency.
(6) Allotment to Be Sent To (name of financial organization)
(7) Signature of Employee
(8) Employee's Savings Account No. At
(9) Date Submitted to Agency
Financial Organization
(10)
We, the above-designated financial organization, hereby agree to act as agent of the above-named Government employee in the capacity
indicated and to accept as our expense, such service charge, at the rate established in regulations of the Department of the Treasury, as will be
deducted from the amount remitted to us. Our complete account number for the savings account to be credited is inserted in Block No. (8), so as
to be included on records accompanying remittances.
THE FINANCIAL ORGANIZATION WILL CHECK WHICHEVER OF THE FOLLOWING PROVISIONS IS APPLICABLE
The address in Block No. (12) is the single point in this financial organization which is to
TO BE
receive remittances for all allotments of pay of Government employees designating this
financial organization. Our "employer identification number" (same as the tax identification
COMPLETED
number assigned by Internal Revenue Service) is inserted in Block No. (11).
We can agree to act as agent of the above-named person in the capacity indicated only if
BY
remittances are forwarded to our respective branch office where the savings account is
maintained. The related branch office for this allotment of pay is identified by the
(11) Employee Identification No.
parenthetical suffix inserted with our "employer identification number" (same as the tax
FINANCIAL
identification number assigned by Internal Revenue Service) in Block No. (11) coordinate
with the address shown in Block No. (12).
ORGANIZATION
(12) Address of Financial Organization
(a) Street
(B)
(b) City
(c) State
(d) Zip Code
(13) Authorized Signature
(14) Title
(15) Date
Agency payroll offices and disbursing offices operate within rigid time schedule to assure timely delivery of checks for net pay on the established
ATTENTION
payday and there will be no change in this emphasis. As requested above, the amount allotted will be deducted from your salaries or wages and will be
remitted by the disturbing office, as soon as practicable, to the designated recipient. It should be understood that such remittance may be received by
EMPLOYEE
the recipient later than the regular payday--possibly 3 or 4 business days later.
AND
PRIVACY ACT STATEMENT 5 USC 5525 permits Federal agencies to collect this information. Executive Order 9397 allows Federal agencies to use
the Social Security number as an individual identifier to avoid confusion caused by employees with the same of similar names. the information
FINANCIAL
furnished on this form is confidential and is needed to provide entitlement to the benefits of the financial arrangement authorized by the authority cited.
The information will be used to process the payment data from the Government agency to the recipient. Failure to provide the information requested
ORGANIZATION
may affect the entitlement to such benefits.
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION USABLE
FINANCIAL ORGANIZATION'S COPY
(a) Complete one form for each savings account.
(e) Employee is to distribute copies as designated.
(b) Employee is to initiate this form.
INSTRUCTIONS
(c) Employee is to complete part A in triplicate.
(d) Financial organization is to complete part B in triplicate.
Standard Form 1198
REQUEST BY EMPLOYEE FOR ALLOTMENT OF PAY FOR CREDIT
(Rev. 3-82)
Department of the Treasury
TO SAVINGS ACCOUNT WITH A FINANCIAL ORGANIZATION
I TFM 3-9000
(1) Name of Employee (As stated on payroll)
(2) Social Security Number
(3) Home Address
(4) Agency (Include also Bureau, Division, Branch or other designation of employing organization)
TO BE
You are hereby authorized, in accordance with 31 CFR part 209, subject to all the conditions stated on this document, to take the action requested
below with respect to deductions from salaries or wages due me in the amount specified below which are for remittance to the financial organization
COMPLETED
designated below, for credit to my savings account. Action will be effective within the next two full pay periods and deductions will continue until
canceled by me in writing.
BY
(5) Action requested on Allotment ("X" one and fill in amount)
Initiate $
Increase from $
to $
EMPLOYEE
(A)
Cancel $
Decrease from $
to $
An authorization for a new or decreased allotment must be completed by the financial organization. An authorization to increase of cancel an
allotment should be submitted directly to the employing agency.
(6) Allotment to Be Sent To (name of financial organization)
(7) Signature of Employee
(8) Employee's Savings Account No. At
(9) Date Submitted to Agency
Financial Organization
(10)
We, the above-designated financial organization, hereby agree to act as agent of the above-named Government employee in the capacity
indicated and to accept as our expense, such service charge, at the rate established in regulations of the Department of the Treasury, as will be
deducted from the amount remitted to us. Our complete account number for the savings account to be credited is inserted in Block No. (8), so as
to be included on records accompanying remittances.
THE FINANCIAL ORGANIZATION WILL CHECK WHICHEVER OF THE FOLLOWING PROVISIONS IS APPLICABLE
The address in Block No. (12) is the single point in this financial organization which is to
TO BE
receive remittances for all allotments of pay of Government employees designating this
financial organization. Our "employer identification number" (same as the tax identification
COMPLETED
number assigned by Internal Revenue Service) is inserted in Block No. (11).
We can agree to act as agent of the above-named person in the capacity indicated only if
BY
remittances are forwarded to our respective branch office where the savings account is
maintained. The related branch office for this allotment of pay is identified by the
(11) Employee Identification No.
parenthetical suffix inserted with our "employer identification number" (same as the tax
FINANCIAL
identification number assigned by Internal Revenue Service) in Block No. (11) coordinate
with the address shown in Block No. (12).
ORGANIZATION
(12) Address of Financial Organization
(a) Street
(B)
(b) City
(c) State
(d) Zip Code
(13) Authorized Signature
(14) Title
(15) Date
Agency payroll offices and disbursing offices operate within rigid time schedule to assure timely delivery of checks for net pay on the established
ATTENTION
payday and there will be no change in this emphasis. As requested above, the amount allotted will be deducted from your salaries or wages and will be
remitted by the disturbing office, as soon as practicable, to the designated recipient. It should be understood that such remittance may be received by
EMPLOYEE
the recipient later than the regular payday--possibly 3 or 4 business days later.
AND
PRIVACY ACT STATEMENT 5 USC 5525 permits Federal agencies to collect this information. Executive Order 9397 allows Federal agencies to use
the Social Security number as an individual identifier to avoid confusion caused by employees with the same of similar names. the information
FINANCIAL
furnished on this form is confidential and is needed to provide entitlement to the benefits of the financial arrangement authorized by the authority cited.
The information will be used to process the payment data from the Government agency to the recipient. Failure to provide the information requested
ORGANIZATION
may affect the entitlement to such benefits.
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION USABLE
EMPLOYER'S COPY

Download GSA Form SF-1198 Request by Employee for Allotment of Pay for Credit to Savings Account With a Financial Organization

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