PerFORM PRO FORM 1.01Request for Information AD354U.S. Dept. of AgricultureMay 1980 -- v 1.0Jk;)C?+.H-HUse this form when requesting retirement records, payroll listing, correction for a terminated employee's W-2 form, or an employee did not receive a W-2 form. QOTHER2 I. DD @@FIELD NAME: "Other (If more space is required, add additional sheets.)" Briefly describe the information requested. Always attach a copy of the source document pertaining to the inquiry for the identification and follow-up.ID_REQ MD!ND AA t]<^<FIELD NAME: "Identification Requested. Please Furnish Copy." -- Press the spacebar to enter an 'X' in this field. BB AGCY_CD . A%B!A&B83 ==FIELD NAME: "Agency Code (3)" -- Default entry for agency code is 83. To change default entry, backspace over 83 and enter the new agency code and press Tab.INQ_CD . 9!9 5])^)FIELD NAME: "Inquiry Code (3)" -- For NFC Use Only.REPLY_CD . :!: 355FIELD NAME: "Reply Code (1)" -- For NFC Use Only.DATE_RECD / B!B 466FIELD NAME: "Date Rec'd (8)" -- For NFC Use Only.DATE_COMP / 5!5 4}5~5FIELD NAME: "Date Comp. (8)" -- For NFC Use Only.CLERK_CD . /!/ .%,&,FIELD NAME: "Clerk Cd." -- For NFC Use Only.ACCT_STATION . 2-!2-4400 5060FIELD NAME: "Acct. Station/Employing Office Code (4)" -- Default entry for Acct. Station/Employing Office Code is 4400. To change the default entry, backspace over 4400, enter the new Acct. Station/Employing Office Code and press Tab.EMP_NAME . -44 M1N1FIELD NAME: "Employee Name" -- Enter employee name (lastname, firstname, mi), Vendor, Traveler, Cashier, Claimant, or Casual.SCHED_NO . FF 8LLFIELD NAME: "Schedule/PP No." -- Enter the pay period.SALARY eC!fC VBUB FFFIELD NAME: "Salary/Allowance" -- Press the spacebar to enter an 'X' in this field. Attach a copy of the source document pertaining to the inquiry for the identification and follow-up. LL SF-2806 5B!6B BB L88FIELD NAME: "SF-2806" -- Press the spacebar to enter an 'X' in this field. 66 W2_TAX_YR1 7!7 << R 77FIELD NAME: "W-2 for Tax Year" -- Press the space to enter an 'X' in this field. ?? GRADE_CHG1 I!I 6858 RHHFIELD NAME: "Grade Changes" -- Press the spacebar to enter an 'X' in this field. ?? PAYROLL1 E<!F< @@ `EEFIELD NAME: "Payroll Listing for Year(s)" -- Press the spacebar to enter an 'X' in this field. E7F7 PAY_ADJ1 ED!FD ?? S%A&AFIELD NAME: "Pay Adjustment" -- Press the spacebar to enter an 'X' in this field. 55 WGI1 >!> .>-> Y CCFIELD NAME: "Grade changes: WGI" -- Press the spacebar to place an 'X' in this field. 66 CAS_TIME1 C!C V;U; P@@FIELD NAME: "Casual Time" -- Press the spacebar to enter an 'X' in this field. 99 UNIFORM1 L!L II NmInIFIELD NAME: "Uniform" -- Press the spacebar to place an 'X' in this field. HH PAY_DOC }I!~I CC ]@^@FIELD NAME: "Payroll/Personnel Documents" -- Attach a copy of the source document pertaining to the inquiry for the identification and follow-up. Press the spacebar to place an 'X' in this field. @@ CHECK_BOND =6!>6 >9=9 GGFIELD NAME: "Check/Bond" -- Press the spacebar to enter an 'X' in this field. Attach a copy of the source document pertaining to the inquiry for the identification and follow-up. ]I^I TRVL_VCHR" 6!6 FF GGFIELD NAME: "Travel Voucher/Advance" -- Press the spacebar to enter an 'X' in this field. Attach a copy of the source document pertaining to the inquiry for the identification and follow-up. FF FEDSTRIP( E!E .I-I }L~LFIELD NAME: "FEDSTRIP/Motor Pool" -- Press the spacebar to enter an 'X' in this field. Attach a copy of the source document pertaining to the inquiry for the identification and follow-up. UIVI GBL* L!L fLeL LLFIELD NAME: "GBL/GTR/CBL" -- Press the spacebar to enter an 'X' in this field. Attach a copy of the source document pertaining to the inquiry for the identification and follow-up. LL IMPREST, L!L M M FIELD NAME: "Imprest Fund" -- Press the spacebar to enter an 'X' in this field. Attach a copy of the source document pertaining to the inquiry for the identification and follow-up. MM PHONE1 =!= LL BBFIELD NAME: "Telephone/Utilities" -- Press the spacebar to enter an 'X' in this field. Attach a copy of the source document pertaining to the inquiry for the identification and follow-up. << PO4 L!L LL IIFIELD NAME: "Purchase Order (AD-838)" -- Press the spacebar to enter an "X" in this field. Attach a copy of the source document pertaining to the inquiry for the identification and follow-up. II OTC6 E!E 88 ??FIELD NAME: "Over-the-Counter Purchases (AD-744)" -- Press the spacebar to enter an "X" in this field. Attach a copy of the source document pertaining to the inquiry for the identification and follow-up. m7n7 MISC_PAY8 D!D VHUH -G.GFIELD NAME: "Misc. Pay" -- Press the spacebar to enter an 'X' in this field. Attach a copy of the source document pertaining to the inquiry for the identification and follow-up. ]H^H GAS_CREDIT: @!@ CC ]G^GFIELD NAME: "Gasoline Credit Card" -- Press the spacebar to enter an 'X' in this field. Attach a copy of the source document pertaining to the inquiry for the identification and follow-up. 77 BILLINGS= =N!>N vHuH @@FIELD NAME: "Billings/Collections" -- Press the spacebar to enter an 'X' in this field. Attach a copy of the source document pertaining to the inquiry for the identification and follow-up. =H>H CAS_AGCYE eH!fH HH mHnHFIELD NAME: "CAS/Agency Reporting" -- Press the spacebar to enter an 'X' in this field. Attach a copy of the source document pertaining to the inquiry for the identification and follow-up. HH OTHER1H U7!V7 &?%? IIFIELD NAME: "Other" -- Press the spacebar to enter an 'X' in this field. Attach a copy of the source document pertaining to the inquiry for the identification and follow-up. 5G6G FORM_NO . =G>G E>>FIELD NAME: "Form Number" -- Enter the form number being requested.BLOCK_NO . ]N^N ==FIELD NAME: "Block Number" -- ENTRY . %N&N  IIFIELD NAME: "Entry Should Be"CHECK %=!&= FNEN g=7>7FIELD NAME: "Non-Receipt of (Check one) - Check" -- Press the spacebar to enter an 'X' in this field. GG RCNCL_AGCY# UE!VE FF U5I6IFIELD NAME: "Reconcil. Agency" -- Press the spacebar to enter an 'X' in this field. 77 BOND! <!< HH fHHFIELD NAME: "Non-Receipt of (Check one) - Bond" -- Press the spacebar to enter an 'X' in this field. II PAY_STATUS% G!G E E oLLFIELD NAME: "Payment Status of - Travel Voucher/Advance" -- Press the spacebar to enter an 'X' in this field. II NON_RECEIPT& ;!; EE d5?6?FIELD NAME: "Payment Status of - Non-receipt" -- Press the spacebar to enter an 'X' in this field. ?? DATE_TRVL '/ K!K LLFIELD NAME: "Date of Advance or Period of Travel" -- Enter the date with dashes in the format of "mm-dd-yy". The slashes will convert automatically.FED_STATUS ). uIvI D@@FIELD NAME: "Status" -- Enter the status of the FESTRIP/Motorpool.GBL_STATUS + == :IIFIELD NAME: "Status" -- Enter the status of GBL/GTR/CBL.STAT_FORM- -?!.? DD ZDDFIELD NAME: "Status of Form Number" -- Press the spacebar to enter an 'X' in this field. EE IMPREST_NON. UG!VG DD [ <<FIELD NAME: "Non-Receipt of Payment" -- Press the spacebar to enter an 'X' in this field. u7v7 IMP_FURNISH/ u?!v? GG l%O&OFIELD NAME: "Furnish (Sub) Vouchers for Audit Period" -- Press the spacebar to enter an 'X' in this field. CC PHONE_MSTR2 E!E KK V@@FIELD NAME: "Master File Error" -- Press the spacebar to enter an 'X' in this field. << PHONE_NON3  N!N O O [==FIELD NAME: "Non-Receipt of Payment" -- Press the spacebar to enter an 'X' in this field. 5N6N REQ_CREDIT; 8!8 fMeM \u@v@FIELD NAME: "Request for Master File" -- Press the spacebar to enter an 'X' in this field. mEnE BILL_STATUS> C!C JJ KJJFIELD NAME: "Status" -- Press the spacebar to enter an 'X' in this field. JJ NON_CREDIT< M!M EE _NNFIELD NAME: "Non-Receipt of Credit Card" -- Press the spacebar to enter an 'X' in this field. eJfJ BILL_FURN1? ]L!^L .N-N eNNFIELD NAME: "Furnish (Sub) Vouchers for Audit" -- Press the spacebar to enter an 'X' in this field. =L>L APPL_NO1A >!> CC \HHField Name: "Applicant/Debtor Number" -- Press the spacebar to enter an 'X' in this field. MCNC DOC_NO1C J!J EE TFFFIELD NAME: "Document Number" -- Press the spacebar to enter an 'X' in this field. >> CAS_REPORT F. CC KKFIELD NAME: "Type Report" -- REP_DATE G/ uE!vE ~99FIELD NAME: "Report Date" -- Enter the date with dashes in the format of "mm-dd-yy". The slashes will automatically appear.NFC_REPLY J. KK .==FIELD NAME: "NFC Reply" -- For NFC Use Only.TITLE L. HH CLLFIELD NAME: "Title" -- Enter the title of the authorizing person.PHONE2 M. K!K>8=8JJ()- }FFFIELD NAME: "Phone (Area code and number)" -- Enter the digits only. The parentheses and dashes will automatically appear.DATE P/ J!J -E.EFIELD NAME: Date -- Enter the date the form is sent. Enter the date with dashes in the format of "mm-dd-yy". The slashes will appear automatically.FTSN K!!K LL HH QLLFIELD NAME: "Phone: FTS" -- Press the spacebar to place an 'X' in this field.COMMO EH!$FH vCuC DD R5H6HFIELD NAME: "Phone: Comm" -- Press the spacebar to place an 'X' in this field.PO_STATUS 5. FF F}E~EFIELD NAME: "Status" -- Enter the status of Purchase Order (AD-838).OTC_STATUS 7 HH Rm@n@FIELD NAME: "Status" -- Enter the status of Over-the_Counter Purchases (AD-744).MISC_STATUS 9. == 8CCFIELD NAME: "Status" -- Enter the status of Misc. Pay.ID_NO . ]9^9 qKKFIELD NAME: "Identification Number" -- Enter Social Security, Account, BOAC, GBL, GTR, or Purchase Order, etc.GRADE_CHG2 . }7~7 !NNFIELD NAME: "Grade Changes" -- PAY_ADJ22 . KK !%6&6FIELD NAME: "Pay Adjustment"-- WGI2_CHG2 . FF mMnMFIELD NAME: "WGI"PAYROLL2 . 77 dMGNGFIELD NAME: "Payroll Listing for Year(s)" -- Enter the year(s) for the requested payroll listings.CAS_TIME2 . OO FFFIELD NAME: "Casual Time"UNIFORM2 . -<.< MMFIELD NAME: "Uniform"W2_TAX_YR2 . H!H IDDFIELD NAME: "W-2 For Tax Year" -- Enter the year for the requested W-2.BALANCEC$. DD mBnBFIELD NAME: "Balance Is:" -- FURNISH2 @. M;N; `<<FIELD NAME: "Furnish (Sub)Vouchers for Audit" -- Enter the period for the requested vouchers.APPL_NO2 B. NN MJJFIELD NAME: "Applicant/Debtor Number" -- Enter the applicant/debtor number.DOC_NO2 D. HH =@@FIELD NAME: "Document Number" -- Enter the document number.FURNISH 0. NN lMMFIELD NAME: "Furnish (Sub) Vouchers for Audit Period" -- Enter the period for the voucher being requested.REPLY_TO K. HH quBvBFIELD NAME: "Mail Reply To" -- Enter first name, last name, middle initial of person form is to be returned to.QSwiss"Courier1Univers (WN)"Modern2Helv"""Va  $ø'mB3X"```I3I3WGIJJJJJJJJJJ܊7'XxC3X"```@EP@FPNON-RECEIPT OF (Check one)qDDw3X"```EJ]PFJ^PGRADE CHANGESD%y3X"```5LuP6LvPPAYROLL LISTING FOR YEAR(S)Ka''C62X"```  OTHER2 uJQvJ OTHER (If more space is required, add additional sheet(s).) f@X<ywX!``` ]JP ^JPNON- RECEIPTø'sB3X "```KPKPUNIFORM~x3X"```?P?PCASUAL TIMESBxX"```8P8PPAY ADJUSTMENTDXyx3X"```GPGPPAYMENT STATUS OFJDX@ywX!``` 5JQ6JQTRAVEL VOUCHER/ADVANCE5DDXX JQJQCHECKq@3p'&u3X K5QK6QIDENTIFICATION NUMBER*pN'1J3XGBMQ GNQSOCIAL SECURITY, ACCOUNT, BOAC, GBL, GTR, PURCHASE ORDER, ETC.Pnp'`u3X!```E@2UQ F@VQIDENTIFICATION REQUESTED. PLEASE FURNISH COPY.v ,'e7u3X  ID_REQ 3P0 >&H?XHNQ HQUNITED STATES DEPARTMENT OF AGRICULTURE  REQUEST FOR INFORMATIONp >DPn?`3X"``` AGCY_CDOQ OQAGENCY CODE (3) DObPnK `3X"` INQ_CD57Q 67QINQUIRY CODE (3) [PnR`X ]EQ^EQ-2D >"O?K3XNQNQFOR NFC USE ONLYbOPPn K4`3X"` REPLY_CDNR NRREPLY CODE (1) POPn4Kx`3X"` DATE_RECDeE R fERDATE REC'D (8) ODePnyK`3X "` DATE_COMPmC%R nC&RDATE COMP. (8) dO"PnK`3X"` CLERK_CDN=R N>RCLERK CD. (2) " >'Pn?C`3X"` ACCT_STATIONuN-UR vNVRACCT. STATION/ EMPLOYING OFFICE CODE (4) qpPn"`u3X"``` EMP_NAMEUNAmR VNnRNAME (Employee, Vendor, Traveler, Cashier, Claimant, Casual) f"On'`Cu3X"` SCHED_NO6R 6RSCHEDULE/PP NO. q?)!'uDX"```GRGRINSTRUCTIONSf''uC3X""``EL$R FLR Check type inquiry and information requested. If information requested is not described below, check type inquiry and briefly describe information requested in the "Other" block. Always attach a copy of the source document pertaining to the inquiry for the identification and follow-up..܊'x3X```5R5RTYPE INQUIRY.܊'xC3X"```-JR.JRINFORMATION REQUESTED.Ƹ/,,*'63X  SALARY *܊6x3X"``` 5E S 6ESSalary/ Allowance܊Dx3X!``` e8Sf8SSF-2806q@܊D%x3X "```]8=S^8>SW-2 FOR TAX YEAR܊x3X  SF-2806 ܊zx3X  W2_TAX_YR1 D83X  GRADE_CHG1 Dz83X   PAYROLL1 \x3X  PAY_ADJ1 ø3X  WGI1 z\x3X  CAS_TIME1 øz3X  UNIFORM1 D'C3X>CAS/Agency Reporting܊D7x3X"``` FORM_NOKS KSFORM NUMBER Df7/3X"``` BLOCK_NOMS MSBLOCK NUMBER /q'7/C3X"``` ENTRYmGS nGSENTRY SHOULD BE /qqT$//X܊ DXx3X  CHECK ܊XDyx3XC,S CSRECONCILE. AGENCY BALANCE IS: ܊#eyx 3X  RCNCL_AGCY DA6XDX!``` MTMTBONDq@D D8X3X  BOND D#e8y 3X  PAY_STATUS #e\yx 3X  NON_RECEIPT \X'yC3X"``` DATE_TRVLM'-T M.TDATE OF ADVANCE OR PERIOD OF TRAVELq܊y'xC.3X"``` FED_STATUSM5TM6TSTATUS JU܊'x.CD3X"``` GBL_STATUS J]TJ^TSTATUS JU܊DxD[3X"```MuTMvTSTATUS OF FORM NUMBERJ܊kxM[3X  STAT_FORM DDx[3X!``` KT KTNON-RECEIPT OF PAYMENT'nxDCM3X "```O*TOTFURNISH (SUB)VOUCHERS FOR AUDIT PERIODDk8M[3X  IMPREST_NON k\xM[3X  IMP_FURNISH ܊Dx[q3X!``` %KT &KTMASTER FILE ERRORD'[Cq3X!``` uKT vKTNON-RECEIPT OF PAYMENT܊"xcq3X  PHONE_MSTR D"8cq3X  PHONE_NON ܊`D1x2X!``` %<&<REQUEST FOR MASTER FILE܊!k1x2X  REQ_CREDIT ܊1DIx2X!``` }G~GSTATUSW܊9Ix2X  BILL_STATUS D`'1C2X!``` ]C^CNON-RECEIPT OF CREDIT CARDD!k812X  NON_CREDIT D1x2X G*GFURNISH (SUB)VOUCHERS FOR AUDIT PERIODKD8I2X  BILL_FURN1 0`x2X "```GGAPPLICANT/DEBTOR NUMBERJ\Ix2X  APPL_NO1 c1'C2X "```]M^MDOCUMENT NUMBERJcI2X  DOC_NO1 ܊Iaxx2X"``` CAS_REPORTMMTYPE REPORT JI'axC2X"``` REP_DATE%M&MREPORT DATE J''6C2X"```  NFC_REPLY GGNFC REPLY f *y܊6x.3X"``` =T =TFEDSTRIP/ Motor Pool*܊6.xD3X"``` %FT&FTGBL/GTR/CBL*܊6Dx[3X"``` NUNUImprest Fund*܊6[xq3X"``` MH5U NH6UTelephone/ Utilities*܊6qx3X"``` =?=U >?>UPurchase Order (AD-838)*܊=6x3X"``` F&UU FVUOver-the-Counter Purchases(AD-744)*=܊`6x3X"``` -MmU.MnUMisc. Payq*`܊16x2X"```  KKGasoline Credit Card܊'xqC3X"``` PO_STATUS5MU6MUSTATUS JU܊'=xC3X"``` OTC_STATUSNUNUSTATUS JU܊='`xC3X"``` MISC_STATUS==U>=USTATUS JUN?Pn'J`3X"```  ID_NO D<FiX  GRADE_CHG2   FEX  PAY_ADJ22  F' C3X  WGI2_CHG2  8PpX  PAYROLL2  PX  CAS_TIME2  gG'C3X  UNIFORM2  УPR3X  W2_TAX_YR2  gy X  BALANCE  79`wX  FURNISH2  o XX  APPL_NO2  '`C2X  DOC_NO2  x9(~LC[3X  FURNISH  /V: a  KVD+Tf2X  uOtvOU.S. Department of Housing and Urban Development 451 - 7th Street, SW, Suite 2260 Washington, DC 20410 ATTN: Ȩ0^&ZX OOAGENCY NAME AND ADDRESS9GAJXh,UX OOMAIL REPLY TO:0'C2X"```OOAUTHORIZED SIGNATURE 0'.C2X"``` TITLEOOTITLE 0/'C2X"``` PHONE2O!OPHONE (Area code and number) 0'>C2X"``` DATEOODATE / 7+2XOOFTS/'7+C2XOOCOMM8 +2X  FTS 8'+C2X  COMM /d(+CX"``%P&PForm AD-354 (5/80)Jtda  REPLY_TO