Purchaser Eligibility Certification - Word - FDIC 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling in the 'Payee' section with your business name or financial organization, if applicable. This ensures that the check is issued correctly.
3. Enter your Social Security Number (SSN) or employee identification number in the designated field for proper identification.
4. If applicable, provide the co-payee's information if the payee is a financial organization. This helps in processing payments accurately.
5. Fill out the address where the check was originally mailed, including the 9-digit ZIP Code, and ensure it matches your records.
6. Indicate any discrepancies by providing a correct mailing address if different from what was previously listed.
7. Select the purpose for which the check was issued by marking the appropriate box (e.g., Regular Pay, Travel Pay).
8. Specify whether you did not receive the check or if it was received but lost, stolen, destroyed, or mutilated by checking the relevant options.
9. Certify your request by signing and dating where indicated. Ensure all signatures are completed to avoid delays.

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