Claim Against the United States for the Proceeds of a Government Check

This series of forms are used to collect information needed to process an individual's claim for non-receipt of proceeds from a U.S. Treasury check or electronic benefit payments. Once the information is analyzed, a determination is made and a recommendation is submitted to the program agency to either settle or deny the claim.

The latest form for Claim Against the United States for the Proceeds of a Government Check expires 2021-10-31 and can be found here.