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Get Treasury FS 1522 2016

522 Department of the Treasury Bureau of the Fiscal Service (Revised May 2014) Visit us on the Web at www.treasurydirect.gov OMB No. 1535-0004 FOR OFFICIAL USE ONLY TRANSFER MONTH & YEAR / FISCAL AGENT CODE IMPORTANT: Follow instructions in filling out this form. You should be aware that the making of any false, fictitious, or fraudulent claim or statement to the United States is a crime that is punishable by fine and/or imprisonment. PRINT IN INK OR TYPE ALL INFORMATION.

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