Judgment Fund Group U.S. Postal Service Department of the Treasury Law Department Financial Management Service Claims Division Prince George's Metro Center 2 Washington, D.C. 20260 3700 East-West Highway Mailstop 6D37 Hyattsville, MD 20782 (Telephone: 202-874-8380)
Re: (Case Name and Court Docket No.)
Enclosed for payment is a copy of a [judgment or settlement agreement] for back pay in this case in the amount of $. All necessary approvals have been obtained and no further review of this matter will be taken. Therefore, payment may now be made in accordance with the provisions of 31 U.S.C. § 1304.
Deductions[FN1] for sums to be withheld for federal taxes, retirement benefits, state taxes, life insurance, etc. are as follows:
FN1. Note that for any deductions to be withheld by FMS, the amount(s) thereof must either be set forth in the judgment, settlement stipulation or other appropriate court order accompanying this letter or be contained in a separate letter from plaintiff or plaintiff's counsel to FMS.
Social Security Number:
State Address: (where deduction for state taxes is to be sent)
Federal taxes $
State taxes $
Retirement benefits $
All other pertinent information to enable you to process this matter for payment is included on the attached Adverse Judgment Data Sheet.
Please send the check(s) in payment of this settlement to me. I shall arrange for the delivery of the check(s) to the payee(s) upon the entry of a dismissal or an appropriate release.If you have any questions concerning this matter, please call me on (telephone number). Thank you for your cooperation.
(Name Title, and Branch, Section or District)
Branch or Section Division U.S. Department of Justice Washington, D.C. 20530
[cited in JM 4-10.110]