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PURPOSE OF FORM The local agency issuance personnel record over-the-counter ECC vault cards issued and damaged/unusable cards.

USE OF FORM Must be updated after the vault card is linked with the case in the VA-ECC Administrative Terminal, or when it is determined that a card is defective.

COPIES Issuance personnel must retain this log for the current month and submit to the local agency designee responsible for managing the vault card supply.

INSTRUCTIONS FOR PREPARING THE FORM The Issuance Worker must complete the log with the 16 –digit card number, card status, case number, case name, cardholder name and Issuance Worker initials. Only the 16-digit card number, card status and initials must be recorded for defective cards.

Appendix X. Monthly Vault ECC Card Used Report Form Instructions

FORM NUMBER 032-12-0139-00-eng (02/20)

PURPOSE OF FORM This form provides a monthly report of the working supply of vault cards for a local agency or a branch site of the agency.

USE OF FORM The form documents the receipt of cards by the local agency. The form also documents the cards issued or determined to be defective during the month. The agency must consider the amounts issued during the month when requisitioning additional cards.

COPIES The local agency must maintain a monthly record of the ECC cards received, issued, or determined to be defective during the month. If there are multiple issuance sites, each site must complete a monthly record to compile a single agency report. INSTRUCTIONS FOR PREPARING THE FORM – Enter the beginning number of cards in the working supply of cards, the number of cards added to the working inventory, and the number of cards issued from the working supply or determined to be defective during the month. The Cards Issued or Defective total must equal the number of cards listed on the Vault ECC Card Inventory Control Record(s) for the month.