Personal Interview - Intranet Screens (field office or National 800 Number)

Automated 101 System: Screen Package
Table of Contents
1. Account Data ................................................................................................................................................................. Error! Bookmark not defined.
2. Beneficiary Data ............................................................................................................................................................. Error! Bookmark not defined.

A101

ACCOUNT DATA
Ln
No
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7
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19
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24

0
1
C
0
L
U
M
N
*
O
N
E

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7
2345 678 901 234 56 78 9012 345 678 901 23 45 6789 012 345 678 90 12 3456 789 012 345 67 89 0123 456 789
A101
A CC OUNT DA TA
AC CT SA0
NH S SN: SS S S S SS SS
*NH FIR ST NAM E: X XXXX XXX XXX XXX X
LAS T: X XXXX XXX XXX XXX XX XX XX

MID DLE : X XX XX XXXX XXX XXX
SUF FIX : X XX X
* RAC E: X

* NH S EX: X

*TYP E O F A CTI ON C ODE: X
*NH DA TE OF BI RT H (M MDD CCY Y): 9 99 9999 9
DATE OF DE ATH ( MM DDCC YY) : 9 999 99 99
PR OOF OF DE AT H: X
*ANN UIT Y I NVO LV ED (Y/ N): X
MILI TAR Y S ERV IC E CODE : X XX
WC /PD B O FFS ET D ATA ON ICF (Y /N ): X
RAIL ROA D C ODE : XX X
*C RIT ICA L C AS E (Y/N ): X
COMP ASS ION ATE A LL OWAN CE/ QUI CK DI SA BILI TY DET ERM IN AT ION (Y/ N): X
DISA BIL ITY FR EE ZE COD E ( Y): X
AD JUS TED BL IN D ONSE T ( MMD DCC YY ): 999 999 99
CHIL D C ARE DR OP OU T YE ARS : X
BASE YE AR (CC YY ): 999 9
THR U ( CC YY ): 9 999
DIVI DEN D: 999 99 99 9.99
DI VIS OR M ONTH S: 999

R
E
S
E
R
V
E TOTA LIZ ATI ON CO UN TRY COD E: XXX XX
S TAT US COD E: X X
D
LSDP PA YAB LE BI C 1: X XX
A MT 1: 9 99.9 9
BIC 2 : XXX
BI C 3: X XX
A MT 3: 9 99.9 9
BIC 4 : XXX

QC’ S: 99 9
A MT 2: 99 9. 99
A MT 4: 99 9. 99

**** *** *** *** *( LI NE 2 3 R ESE RVE D FO R AP PL I CAT ION S IN FORM ATI ON ) *** ** ** **** *** ***
**** *** *** *** *( LI NE 2 4 R ESE RVE D FO R OP ER A TIN G S YS TE MS I NFO RM A TIO N) ** **** *** **
SCREEN FR
MSO

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A101

BENEFICIARY DATA

Ln
No
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21
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23
24

0
1
C
0
L
U
M
N
*
O
N
E
R
E
S
E
R
V
E
D

1
2
3
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7
2345 678 901 234 56 78 9012 345 678 901 23 45 6789 012 345 678 90 12 3456 789 012 345 6 7 89 0123 456 789
A101
BE NEFI CIA RY DAT A
BE NE SA0
NH S SN: SS S S S SS SS
N H NAME : S SSS SSS SS S S SS SSS SSS SSS SS SS SSSS S S SSS
BN S SN: SS SSS SS SS
*B IC: XX X
BN PI A P OIN TE R: 9
DELA YED CL AIM AN T (Y): X
C OMB INE D F AM IL Y MA XIM UM (Y) : X
*BN FIR ST NAM E: X XXXX XXX XXX XXX X
MID DLE : X XX XX XXXX XXX XXX
LAS T: X XXXX XXX XXX XXX XX XX XX
SUF FIX : X XX X
*SE X: X
*DAT E O F B IRT H (M MDDC CYY ): 999 99 99 9 * PRO OF OF BI RT H: X
RIB LIM ITA TIO N AP PLIE S ( Y): X
RAI LRO AD CE RT IFIC ATI ON (Y) : X
IF W IDO W, PAI D CH ILD IN CAR E B EN EF ITS FOR AT LE AS T 1 MO NTH (Y ): X
CROS S R EFE REN CE S SN: 999 999 999
S TATU S C ODE : X X
C IVIL SE RVI CE ID : XXXX XXX XXX
NH’S DR C: 99
TH RU ( MMY Y): 99 99
*C RIM ES AG AI NST U.S . I NDI CA TO R (Y /N) : X
*LEG END 1: XX XX XX XXXX XXX XXX XXX XX X
LE GEN D 2 : X XX XX XXXX XXX XXX XXX XX XX
LEG END 3: XX XX XX XXXX XXX XXX XXX XX X
LE GEN D 4 : X XX XX XXXX XXX XXX XXX XX XX
*BAN K A CCO UNT ( Y/ N): X
*D IRE CT EXP RE SS (Y/ N): X
RTN: 99 999 999
CDC: 9
DPC ( C/ S): X
D AN: X XX XXXX XXX XXX XXX X
REP PAY EE TYP E: X XX
G UAR DIA N
NEGO TIA TED AC CO UN TABI LIT Y M ONT H
**** *** *** *** *( LI NE 2 3 R ESE RVE D
**** *** *** *** *( LI NE 2 4 R ESE RVE D

ST ATUS CO DE: X
CU STOD Y C ODE : X XX
(M MYY) : 9 999
FO R AP PL I CAT ION S IN FORM ATI ON ) *** ** ** **** *** ***
FO R OP ER A TIN G S YS TE MS I NFO RM A TIO N) * * **** *** **

SCREEN FR
MSOM

The A101 beneficiary data screen propagates to the MACADE screens. This screen
collects/displays data for each beneficiary such as the social security number BIC, name,
sex, date of birth and bank account information. The following specifically describes
fields related to direct deposit bank account, direct express, routing transaction numbers,
deposit account number, check digit code, and deposit payment code.

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