Mock-Up of Revised MCS Screens

MCS Screen Mockup.doc

Application for Lump-Sum Death Payment, 404.390 - 404.392

Mock-Up of Revised MCS Screens

OMB: 0960-0013

Document [doc]
Download: doc | pdf

Current CADR Screen:


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No

0

1

1 2 3 4 5 6 7 8

2345678901234567890123456789012345678901234567890123456789012345678901234567890

1

C

MCS CLAIMANT MAILING ADDRESS CADR SC90

2

0

NH: SSSSSSSSS SSSSS SSSSSSSSSS CL: SSSSSSSSS SSSSS SSSSSSSSSS

3

l


4

u


5

m


6

n

*ADDRESS 1: PPPPPPPPPPPPPPPPPPPPPP ADDRESS 2: PPPPPPPPPPPPPPPPPPPPPP

7

*

ADDRESS 3: PPPPPPPPPPPPPPPPPPPPPP ADDRESS 4: PPPPPPPPPPPPPPPPPPPPPP

8

o

*CITY: PPPPPPPPPPPPPPPPPPPPPP STATE: PP ZIP: PPPPP

9

n

STATE & COUNTY CODE: PPPPPP COUNTY: XXXXXXXXXXXXXXX

10

e


11


COUNTRY: PPPPPPPPPPPPPPPPPPPPPP CONSULAR CODE: PPP

12

r

FOREIGN POSTAL ZONE: PPPPPPPPPPPPPPP

13

e


14

s


15

e


16

r

DIRECT DEPOSIT ROUTING TRANSIT NUMBER: 999999999 ACCOUNT TYPE (C/S): A

17

v

DEPOSITOR ACCOUNT NUMBER: 99999999999999999

18

e

19

d


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DOMESTIC PHONE: PPPPPPPPPP FOREIGN PHONE: PPPPPPPPPPPPPPP

21



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TRANSFER TO: XXXX

23


**************(line 23 reserved for applications information)*****************

24


**************(Line 24 Reserved for Operating Systems Information)***********



Proposed CADR screen showing changes for UDD – Direct Express.


Ln

No

0

1

1 2 3 4 5 6 7 8

2345678901234567890123456789012345678901234567890123456789012345678901234567890

1

C

MCS CLAIMANT MAILING ADDRESS CADR SC90

2

0

NH: SSSSSSSSS SSSSS SSSSSSSSSS CL: SSSSSSSSS SSSSS SSSSSSSSSS

3

l


4

u


5

m


6

n

*ADDRESS 1: PPPPPPPPPPPPPPPPPPPPPP ADDRESS 2: PPPPPPPPPPPPPPPPPPPPPP

7

*

ADDRESS 3: PPPPPPPPPPPPPPPPPPPPPP ADDRESS 4: PPPPPPPPPPPPPPPPPPPPPP

8

o

*CITY: PPPPPPPPPPPPPPPPPPPPPP STATE: PP ZIP: PPPPP

9

n

STATE & COUNTY CODE: PPPPPP COUNTY: XXXXXXXXXXXXXXX

10

e


11


COUNTRY: PPPPPPPPPPPPPPPPPPPPPP CONSULAR CODE: PPP

12

r

FOREIGN POSTAL ZONE: PPPPPPPPPPPPPPP

13

e


14

s

BANK ACCOUNT (Y/N): X DIRECT EXPRESS (Y/N): X

15

e


16

r

DIRECT DEPOSIT ROUTING TRANSIT NUMBER: 999999999 ACCOUNT TYPE (C/S): A

17

v

DEPOSITOR ACCOUNT NUMBER: 99999999999999999

18

e


19

d


20


DOMESTIC PHONE: PPPPPPPPPP FOREIGN PHONE: PPPPPPPPPPPPPPP

21



22


TRANSFER TO: XXXX

23


**************(line 23 reserved for applications information)*****************

24


**************(Line 24 Reserved for Operating Systems Information)***********


File Typeapplication/msword
File TitleCurrent CADR Screen:
Author236746
Last Modified By177717
File Modified2008-05-12
File Created2008-05-12

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