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Check Handling Information APPENDIX I and Procedures 10/18 Page 16
STOLEN/LOST CHECK REPORT
The client must complete a lost or stolen check report as part of the affidavit. In the case of a stolen check, a police report must be filed.
Instructions For Preparation Of Stolen Check Report
Date of Report Date affidavit is signed
Payee Name of person check is made payable to
Address of Payee Address as shown on warrant register, including City, State and ZIP
Home Phone Payee’s home telephone number
Work Phone Payee’s work telephone number
Cell Phone Payee’s cell phone number
Check Number Complete 8 digit check (warrant) number
Amount Entire amount of check, including cents
Date of Check
Date on check
Other ID taken
Check YES or NO
If so, what type
List each piece of stolen ID
Where did theft occur
Check appropriate box, Home – Work – Auto – Other
If Other
Indicate where
Idea Who?
Check YES or NO
If YES box is checked, complete the following 7 questions:
If so, Who:
Person’s name
Description
Best possible description of suspect
Address of suspect
Address of the suspect, including City, State and Zip
Why this Person
Reason this person is suspected
How person is known
How payee knows the suspect
Related
Check YES or NO
TANF Transmittal 65