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West Virginia Income Maintenance Manual Chapter 20

West Virginia Income Maintenance Manual Page 41 Chapter 20 Emergency and Special Assistance Programs

payment since payment to the Funeral Home Director is handled through the Office of Accounting. Red Ink on the original document is reserved for Auditors use only. 20.3.4.E.3 Responsibilities of the Financial Clerk The Financial Clerk will receive the DFA-67-A, Burial Billing Form, from the Funeral Home Director. Upon receipt of this invoice, the Financial Clerk will be responsible for pre-auditing and editing. Items to be reviewed before submittal for payment are: • Federal Employer Identification Number (FEIN) in the upper right-hand corner • County number and mailing address • Legible vendor name and mailing address • Correct payment amount on Line Item 7 or Item 9 • Date of death • Date of interment • Proper signatures and dates entered (blue ink on original) Upon completion of the audit, the Financial Clerk must stamp the DFA-67-A with a certification stamp and sign and date the spaces made by the stamp in blue ink. The financial clerk must also print their name beside their signature. The original and two copies of the DFA-67-A will be submitted to the DFA in the burial packet. The burial packet consists of the DFA-67-A (and two copies), DFA-BU- 1, DFA-BU-2, if applicable, and DFA-BU-3. The completed packet must be submitted to the DFA Policy Unit no later than 3 business days after the receipt from the customer. All back-up material pertaining to the burial will remain in the local office. In order for the Financial Clerk to have a record of burials submitted for payment, a Log for Burial Payments must be maintained in each local office. On this log, the following items are suggested: • Date the DFA-67-A was received for payment • Name of vendor • Name of deceased • Date the DFA-67-A was submitted to the DFA NOTE: The Worker, his Supervisor, the Financial Clerk, and the Funeral Home Director or his designee, must sign their appropriate sections on the original DFA-67-A in blue ink only.