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PolicyNet.1 MSOW MSSICS //Chapter 013
02/07/97 (TN #202)
MSSICS 013.007 Financial Institution Accounts (RFIA)
INTRODUCTION
4.
rhese screens record information such as: the type of financial institution account the account number, the name and
tddress of the financial institution, the value of the account for particular periods, and whether the account is co-owned,
:arns interest and/or is set aside for burial. These screens are available for the claimant, eligible spouse andlor deemors,
teference:
Financial Institution Accounts, POMS SI 0 1140.200
AUTOMATED SYSTEMS FEATURES
B.
When the responses on this screen indicate the presence of potentially countable interest income, the system propagates
:ertain information to the Income Menu (IMEN) and Interest Income (IINT) screens.
When the account earns interest and:
is not set aside for burial, -oris set aside for burial, but the interest does not remain in the burial fund, -oris set aside for burial, the interest remains in the fund, but part or all of the burial funds are determined to be a
countable resource,
he system propagates the following information.
On the Income Menu (IMEN) screen a "Y" is propagated to INTEREST.
On the Interest Income (IINT) screen:
>
>
SOURCE is propagated from INSTITUTION NAME [6-MI,
ID is propagated from ACCOUNT NUMBER [5-01,
9 ADDRESS is propagated fiom ADDRESS [7-01 and
>
TYPE RECEIVED is propagated fiom TYPE OF ACCOUNT [2-MI.
rhe system only propagates the information the first time you transmit a Financial Institution Accounts (RFIA) screen
~ h i c hsatisfies the above conditions. Only one iteration will be propagated. If you later change any of the information
rou have entered you must enter the changes to the Income screens.
FACSIMILE 1: RFIA - FINANCIAL INSTITUTION ACCOUNTS
PAGE 1 OF RFIA
FINANCIAL INSTITUTION ACCOUNTS
[1-cjj
SSSSSsSSS
a
SSSSS SSSSSSSSSS
:YPE OF ACCOUNT: 9
l=CHECKING
2=SAVINGS
3=CREDIT UNION
4=CHRISTMAS CLUB
TRANSFER TO: XXXX
5=TIME DEPOSIT
6-INDIVIDUAL INDIAN MONIES
7=OTHER
IF OTHER, SPECIFY: XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
'olicyNet/MSOM/Financial Institution Accounts (RFIA)
Page 2 of 5
~4-M]
:ARNS INTEREST (Y/N): X
r:-0]
CCOUNT NUMBER: XXXXXXXXXXXXXXXXXXXX
:NSTITUTION NAME: PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP
[7-0]
ADDRESS: PPPPPPPPPPPPPPPPPPPPPP PPPPPPPPPPPPPPPPPPPPPP
PPPPPPPPPPPPPPPPPPPPPP PPPPPPPPPPPPPPPPPPPPPP
110-01
10-OWNED
(Y/N): x
SET ASIDE FOR BURIAL (Y/N): x
PASS EXCLUSION (Y/N): x
1.1.1.-Oj
L'1.2-01
(ESOURCE DISPOSAL AGREEMENT (Y/N): X
PROOF OF DISPOSAL (Y/N): X
13-01(11-01
115--01
iN0THER SOURCE (Y): X
DELETE THIS SOURCE (Y): X
REMARKS (Y1 : X
FACSIMILE 2: RFIA - FINANCIAL INSTITUTION ACCOUNTS
FINANCIAL INSTITUTION ACCOUNTS
PAGE
OF RFIA
rl-o]
sSSSSSSSS
lESOURCE ID
TRANSFER TO: XXXX
SSSSS SSsSSSsSSS
[16-D]
SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSssssssssssssssssssss
:O-OWNER[la-C][19-C]
(Y/N) FROM
TO
X
9999 9999
X
9999 9999
X
9999 9999
X
9999 9999
X
9999 9999
X
9999 9999
X
9999 9999
X
9999 9999
X
9999 9999
9999 9999
X
X
9999 9999
X
[SO-0]
NAME
ssSsSSSSsSsSSSS
sSSssSSsSssSSsS
ssssSSSSSSSSSss
SSSSSssSsSSSSsS
SSSSSSSssSSSSSS
SSSsSSsSsSSSSSS
SSSSSSSssSsSSSS
SsssSSSSsssSSSS
sSsSSSSSsSSSSSS
sSSSsSSSSSSSSSS
sSsSsSSSSsSSSSS
OTHER CO-OWNERS
SSSSSSSSSSSsSss
SssSSSSSSSSSSSs
sSSSSSSsSSSSSSS
SSSSsSSSSsSSSsS
SSSSSSSSsSSsSSS
sSSSsSSSsSSSSSS
sSSSSSSsSSSSSSS
SSSSSssSSSSSsSS
SSSSSSSSSSSSSSS
SSsSSSSSsSSSSSS
SSsSSSSSSSSSSSS
SSsSSsssssSSSSSSSSSS ssss
sSSSSsSSSSSSSSSSSSSS ssss
SSSSSSsSSSSSSSSSSSSS SSSS
ssSSSSSSSSSSSSSSSSSS ssss
SSSSSSSSSSsSSSSSSSSS ssss
SSSSSSSSsSsSsSSSSSSS ssss
SSSSSSSSSSSSsSSSSSSS ssss
SSSSsSSSSSSSSsSSSSsS ssss
SsSSSSSSSssSSsssSSss SSSS
SSSSsSSsSsSSSsSSSSSS ssss
SSsSSSSSSSSsSSSsSSSS ssss
115-01
REMARKS (Y): X
13-01
\NOTHER SOURCE (Y): X
FACSIMILE 3: RF'IA - FINANCIAL INSTITUTION ACCOUNTS
fSSICS
FINANCIAL INSTITUTION ACCOUNTS
PAGE
OF RFIA
[1-ol
SSSSSSSSS
SSSSS SSSSSSSSSS
TRANSFER TO: XXXX
[IS-D)
LESOURCE ID SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS
;PECIFY OTHER CO-OWNERS:
,18-C][19-Cl[21-C]
'ROM TO
NAME
1999 9999 XXXXXXXXXXXXXXX XXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXX XXXX
1999 9999 XXXXXXXXXXXXXXX XXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXX XXXX
)999 9999 XXXXXXXXXXXXXXX XXXXxXXXXXXXXXX XXXXXXXXXXXXXXXXXXXX XXXX
1999 9999 XXXXXXXXXXXXXXX XXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXX XXXX
113-01
115-01
\NOTHER SOURCE (Y): X
REMARKS (Y): X
FACSIMILE 4: RF'IA - FINANCIAL INSTITUTION ACCOUNTS
1SSICS
SSSSSSSSS
16-01
lESOURCE ID
FINANCIAL INSTITUTION ACCOUNTS
SSSSS SSSSSSSSSS
PAGE
OF RFIA
11-01
TRANSFER TO: XXXX
SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSssssssssssssssssssss
122-Nj
iET ASIDE FOR BURIAL OF: 9
1-CLAIMANT
2=CLAIMANT1S SPOUSE
3=LIVING WITH FATHER
$=LIVING WITH MOTHER
'
'olicyNet/MSOM/Financial Institution Accounts (RFIA)
Page 3 of 5
113-C]
5-OTHER
:F OTHER, NAME: XXXXXXXXXXXXXXX XXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXX XXXX
)ATE ASSET SET ASIDE (MMDDYY): 999999
25-i.il
CESOURCE EARNS INTEREST (Y/N): P
[26-.C]
IF RESOURCE EARNS INTEREST, INTEREST REMAINS IN FUND (Y/N): X
1.13-01
115-03
\NOTHER SOURCE (Y): X
REMARKS (Y): X
FACSIMILE 5: RFIA - FINANCIAL INSTITUTION ACCOUNTS
1SSICS
FINANCIAL INSTITUTION ACCOUNTS
SSSSSSSSS
SSSS SSSSSSSSSS
PAGE
OF RFIA
TRANSFER TO: XXXX
16-D]
ESOURCE ID SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS
[27-MI
128-MI
129-Cl
[30-C]
131-01
13%-Dl
FROM
TO
ALLEGED
VERIFIED
EXCLUDED
COUNTABLE
(MMyy)
(MMYY)
VALUE
VALUE
AMOUNT
AMOUNT
PPPP
999999999
999999999
PPPP
SSSSSSSss
999999999
999999999
999999999
999999999
9999
9999
SSSSSSSsS
999999999
9999
999999999
999999999
SSSSSSSSs
9999
999999999
999999999
sSSSSSSsS
9999
999999999
9999
999999999
999999999
999999999
9999
9999
SSSSSSSSS
9999
999999999
999999999
999999999
9999
sSsssSsSS
999999999
999999999
SSSSSSSSS
9999
999999999
9999
999999999
999999999
999999999
9999
9999
SSSSSSSSS
999999999
999999999
999999999
9999
9999
SSSSSSSSS
9999
999999999
999999999
9999
999999999
SSSSSSSSS
9999
9999
999999999
999999999
999999999
SSSSSSSSS
999999999
999999999
999999999
SSSSsSSSS
9999
9999
999999999
9999
999999999
999999999
SSSSSSSSS
9999
9999
9999
999999999
999999999
999999999
SSSSsSSSS
33-C]
:XCLUSION REASON: XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
'13-01
134-01
CONTINUATION SHEET (Y): X
NOTHER SOURCE (Y): X
115-0!
REMARKS (Y): X
COMMON FIELDS
11-01 TRANSFER TO: XXXX
:8-01 CO-OWNED (Y/N): X
19-01 SET ASIDE FOR BURIAL (Y/N): X
10-01 PASS EXCLUSION (Y/N): X
11-01 RESOURCE DISPOSAL AGREEMENT (Y/N): X
:12-01 PROOF OF DISPOSAL (Y/N): X
:13-01ANOTHER SOURCE (Y): X
14-01 DELETE THIS SOURCE (Y):X
:I5-01 REMARKS (Y): X
116-Dl RESOURCE ID: SS[MAXIMUM OF 60 CHARACTERS]SS
17-MI CO-OWNER (Y/N): X
'olicyNet/MSOM/Financial Institution Accounts (RFIA)
Page 4 of 5
'18-C] FROM: 9999
:19-C] TO: 9999
20-DINAME: SSSSSSSSSSSSSSS SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS
SSSS
:21-C] NAME: XXXXXXXXXXXXXXX XXXXXXXXXXXXXXX
X
X
X
X
~
X
X
X
X
X
X
'22-MI SET ASIDE FOR BURIAL OF: 9
'23-C] IF OTHER, NAME: XXXXXXXXXXXXXXX XXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX XXXX
124-MI DATE ASSET SET ASIDE (MMDDYY): 999999
127-MI FROM (MMYY): PPPP
:28-MI TO (MMYY): PPPP
:29-C] ALLEGED VALUE: 999999999
:30-C] VERIFIED VALUE: 999999999
:31-01 EXCLUDED AMOUNT: 999999999
:32-Dl COUNTABLE AMOUNT: SSSSSSSSS
'33-C] EXCLUSION REASON: X X W M U M OF 40 CHARACTERSIXX
:34-01 CONTINUATION SHEET (Y): X
Xeference:
[.
MSOM MSSICS 012.001
FIELD DESCRIPTIONS
[2-MI TYPE OF ACCOUNT: 9
Enter the number (1 -7) that corresponds to the type of account.
PC1
IF OTHER, SPECIFY: XX[MAXIMUM OF 40 CHARACTERSIXX
Enter the specific type of account & if TYPE OF ACCOUNT 12-MI = 7 (other).
[4-MI EARNS INTEREST WIN): X
[5-01 ACCOUNT NUMBER: XX[MAXIMUM OF 20 CHARQCTERSIXX
Allowable characters are any alpha, numeric, space or hyphen.
'oli~yNet/MSOM/FinancialInstitution Accounts (RFIA)
Page 5 of 5
[6-MI INSTITUTION NAME: PP[MAXIMUM OF 40 CHARACTERSIPP
For each subsequent Financial Institution Account collected, the system pre-fills INSTITUTION NAME with
the name of the financial institution from the preceding occurrence of this screen. It can be overkeyed as
necessary.
[7-01 ADDRESS: PP(UP TO 4 LINES MAXIMUM 22 CHARACTERS EACH)PP
For each subsequent Financial Institution Account collected, the system pre-fills ADDRESS with the address of
the financial institution from the preceding occurrence of this screen. It can be overkeyed as necessary.
RESOURCE EARNS INTEREST (YIN):P
This is pre-filled with the response to EARNS INTEREST 14-MI. If you change the value in this field, the
system will change the value in the EARNS INTEREST field [4-MI to correspond.
IF RESOURCE EARNS INTEREST, INTEREST REMAINS IN FUND
Enter a "Y" or "N" o&if
RESOURCE EARNS INTEREST [25-MI = Y
RELATED REFERENCES
ncome Menu (IMEN), MSSICS 014.002
nterest Income (IINT), MSSICS 015.01 8
P_rg&!ie.us
Nat
Make Note
.ink to this section:
ittp://policynet.ba.ssa.gov/msom.nsf/links/MSSICSO
13007
| File Type | application/pdf |
| File Modified | 2007-05-29 |
| File Created | 2007-05-29 |