Last document on file, November 1981

Produced by optical character recognition, uncorrected. These are carbon copies and mimeographs from 1941–46, so the reading is rough — treat it as a finding aid for search, not as a transcript. The scan above is the record.

UNITED STATES
OFFICE OF PERSONNEL MANAGEMENT
RETIREMENT AND INSURANCE PROGRAMS
WASHINGTON, B.C, 20418

11-9-81

“alvin G. Cline Sk OF- 8918

626 W. Rusholme
Davenport, IA 52803

The attached Authorization for Deposit of Federal Recurring Payments (SF-1199A) is

© to financial organization

being returned { fro the reason(s) indicated below.

2 to annuitant/survivor annuitant
Incorrect form was submitted—Must use the SF-1199A.

SF-1199A was not legible.

Claim Number or Prefix missing or incorrect.

Claim Number incorrect (Does not match account name)

Claim Number incorrect (No such number on file).

Account Inactive—Cannot complete action.

Name of Recipient missing.

Mailing Address of Recipient missing or incomplete.

Signature of Recipient missing or unacceptable.

Financial Organization Routing Number or Check Digit missing or incorrect.
Depositor Account Number or Account Designation (C or S) missing or incorrect.
Depositor Account Title missing or incorrect.

Signature of Financial Organization Officer missing.

Not Civil Service Annulty—please forward to proper agency.

nooononooonnonooOooOfPoG

Other:

149-409
Rov. Maren 1981

— — —

an ®

AUTHORIZATION FOR DEPOSIT OF FEDERAL RECURRING PAYMENTS

RECIPIENT (PAYEE) TO COMPLETE ITEMS A THROUGH J

request tho below indicated program agency to direct the
ng my (our) account indicated’ at the financial organ he author
Besignment of my (our) right to receive payment and revokes all prior pay fons applicable to these payments
wel understand that the financial organization designated reserves the right to cancel thie agreement by novice to me los
however, this authorization will main in effect with the progeam agency until Canceled by notice from fe [u).

pa

‘A eLaiw OF FILE NUNOER TYPE OF PAYMENT

gEFIR |] CCAIM NUMBER for al paymrant UFFTE OR PAYEE WO]
or ESE © RRB) = Y Virsppicesiy cose Annuity

483-09-5410

| DNANEIST OF REEIPIENTIaT OF FUNDS

‘Enter °C" Checking Aceount or “Sf Sevinds Account

Alvin G. Cline "V___[oerosiron accounr numoen
c 00120005994
[ F-WATLING ADORESS OF REGIPENTST ‘G WANE GF PERGONISI FOR WHOM PAYMENT 15 WADE (The par

cusorrn"""" avin G. Cline

TWF SURVIVOR ANRUITANT, GIVE NAME OF DECEASED (056 wi)

£26 West Rusholme _

‘Biro Naber and

aq Pavenport, IA 5280

Gig. Sere ane
‘ace aX" nthe box i addres a dierent rom the abdross

Io ech Oa ene ie (319) 323-9343
TRoNATUREIS! OF RECIPIENTISI ON WiTNESEES/Seehwrocian one
SIGNATURE < SIGNATURE

| oh Z CBs 10/2/81

FINANGIAL ORGANIZATION TO COWPLETE BELOW THIS LINE

We, the below ted financial organization, hereby agree to receive and depasit sums for the payools) named herein, in accor
Bese dea he inant 92209, on 210, We understand that our account umber shown for the payests) named herein will be
included on individual payment credits to his (their) account, We understand that the payse(s) named above has (have) the right
{to cancel this authorization and we reserve the right to cancel this agreement by notice to the

eels)

ROTTING NOWDER ‘HECK DIGIT | RAE” ANG ABORESS oF FINANCIAL ORGANEATION
Citizens Federal Savings and
2|{ 7/3 | 7] off 2]] 8 7 Loan Assocaition

101 W. 3rd St.
Davenport, Iowa 52801

TYPE ANO NUMBER OF OEPOSITOR ACCOUNT TO BE CREDITED
air “C° Chechng Account of “5° Savings Rese
‘DEPOSITOR ACCOUNT NUMBER

¥
fic 00120005994
DEFORTOR RECOUNT THLE ‘BRANCH DESIGNATION, IF APPLIGROTE

Alvin G. Cline and Mavis J. Cline EERE Toe

aS , (319) 322-6237

TREE Bare
|___Asst/ Secret: 19/2/81
SURED THERE TS WO FEDERAL NOTAREAT INERT

The payeels) whose signeturels) appeard above personally appeared before me, presented talislactory Wdentificeon, aed, after
boing duly sworn, acknowledged this tobe his her) (une) freely given act snd dos Sc

Notary Public pate Seal

pwn sn on te tum enn ng pind sor

Pores ta ma eet od tent gun parone Ta 3] U. pcg tg rnp CFR Poss
ea a ee ete tt el tan he cas is TUS. dn vn 1 CFR Pu 30
Fe ae ri ia sitar igs wll Saiki latest ts etna ene pepe net

PROGRAM AGENCY Copy