Downloading a Form to Your Computer

  1. Right Click for PC or Ctrl + Click for Mac on the PDF link and click “Save link as” from the menu.
  2. Select the folder you want to save the file in and then click "Save."
  3. Navigate to the folder you saved the file in and Right Click for PC or Ctrl + Click for Mac, then select "Open With" from the menu and select Adobe Acrobat Reader DC.

    Note: Open the PDF file from your desktop or Adobe Acrobat Reader DC application. Do not click on the downloaded file at the bottom of the browser since it will not open the PDF in Adobe Acrobat Reader DC. It will try to open the file in the browser that results in the same browser error message.

    If still having trouble viewing or downloading a form, click here.

Effective Date: 
5/2016

Documents

Instructions

Updated: 10/2002

Purpose

To request information about clients' bank accounts.

Procedure

When to Prepare

The case manager sends Form H1239 to a bank to get information about the bank accounts of a client.

Number of Copies

The case manager completes an original and makes a note on Form H0007-A, Activity Record, or prepares a copy for the case record. (Follow regional instructions).

Transmittal

The case manager sends the original to the financial institution.

Form Retention

If a copy is made for the case record, keep the copy according to the retention requirements of the case record.

Detailed Instructions

Inside Address — Enter the name and address of the financial institution.

Enter the date, name of the case manager, and the office mailing address and telephone number.

Enter the name of the client. Enter the account number(s), if known.

Enclose Form H0003, Authorization to Furnish Information, and a return envelope.