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VIRGINIA DEPARTMENT

OF SOCIAL SERVICES ENERGY ASSISTANCE

06/16 VOLUME IX, CHAPTER E, PAGE 5

2) Underpayments - Complete a COPE form. A copy of the local check, made payable to the client or the vendor as appropriate, correcting the error must accompany the COPE form. The COPE form is to be completed in triplicate with the original COPE form and a copy of the check sent to the Regional Consultant, if the underpayment was for a client. A copy of the COPE form and a copy of the check are sent to the Vendor Coordinator if the underpayment was for a vendor. The LDSS should retain a copy of the COPE form and the local check for their records. 5. LOST AND STOLEN CHECK PROCEDURES a. Client Checks (All EAP components) 1) Confirm that the check has been sent by checking the Inquiry on Payment History in the system. The seventh column on the screen will show either a "P" for pending payment or an "H" for history. If an "H" is indicated, the payment was issued on the date indicated in column four. 2) After the seventh mail delivery day, the fuel worker or an authorized person in the LDSS will have the client sign three original notarized affidavits stating the client has not endorsed the check and complete a W-9, Request for Taxpayer Identification Numbers and Certificate form (W-9 form). The Affidavit on Check Endorsement must be used for this purpose. A locality may also have a locally designed affidavit signed as a supplement to the VDSS form. The affidavit must contain the correct social security number (SSN) or the correct employer identification number (EIN). 3) The locality must obtain two original affidavits, an original Stop Payment Request, and an original W-9 form. One original affidavit (including two original Affidavit of Check Fraud by Payee [Wells Fargo Bank] forms), the original Stop Payment Request, and the original W-9 form must be sent to the Division of Finance, Processing Unit. In addition, one original affidavit and a copy of the Stop Payment Request form and a copy of the W-9 form will be retained in the case record. If the LDSS chooses, they may make additional originals or copies of the affidavit and/or the Stop Payment Request and the W-9 form for use in coordinating with other agencies or city/county personnel. 4) The LDSS will prepare a Stop Payment Request. The Stop Payment Request and Affidavit on Check Endorsement must contain the exact information reflected on the warrant register for the check, except for the address on the affidavit. The client must enter the current address on the affidavit. On the Stop Payment Request, if the client has moved, include the new address in the comment section along with other pertinent information. TRANSMITTAL #16-1