SAMS1100 Cash Transmittal

Single Family Acquired Asset
Management System (SAMS)

U.S. Department of Housing
and Urban Development
Office of Housing
Federal Housing Commissioner

Cash Transmittal
1. HOC Area Identifier

2. HOC Area Name

3. M & M's NAID

4. M & M's Business Name

5. Form HUD-235.1 Receipt Number

6. Check Amount (one check per form)

7. Check Date (mm/dd/yyyy)

8. Check Issuer's Name

For Rent
Receipts
Only

9. Lease Number

10. Unit Number

Note: All checks and money orders must be either payable to HUD or endorsed to HUD (See instruction on back of page).
If not, the check or money order will be rejected and returned to the proper HUD office.
11. FHA Case Number

12. Post Code

15. Total Amount This Page
Allocated (Non-case specific)Post
Codes
AD Advertising
AF Misc. Collection
Case Specific Post Codes

CF
EF
EM
EX
IS

13. Amount

14. Property Address

$

Condo/HOA Fees Refund
Earnest Money Forfeiture
Earnest Money
Sales Extension Fee
Insurance Refund

LQ
MC
MI
MM
MR

Liquidated Damages
Misc. Sales Expense
Misc. Income
M & M Fee Refund
Misc. Major Repair

PP
RT
TR
TX
UT

P & P Recoveries
Rent
Termite Inspection Refund
Tax Refund
Utilities/Fuel Oil Refund

To the best of my knowledge, all the information stated herein, as well as any information provided in the accompaniment herewith, is true and accurate.
Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802)
16. Preparer's Signature

17. Title

18. Phone Number (Area Code) 19. Date Signed (mm/dd/yyyy)

X
Previous editions are obsolete

Page 1 of 2

form SAMS-1100 (3/99)
ref Handbook 4310.5

Public reporting burden for this collection of information is estimated to average 12 minutes per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency
may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number.
This information enables HUD to record and process financial transactions in its automated Single Family Acquired Asset Management System (SAMS) to
dispose of acquired single-family properties. HUD reimburses M&M Contractors for their services in maintaining, marketing, and selling HUD homes, and HUD
collects funds associated with the sales of these properties. The information enables HUD to create and maintain sound financial management practices and
effective internal controls over the property disposition program. A response is required to obtain or maintain a benefit.

Instructions for Completion of Form SAMS-1100
(Please use typewriter or print in ink)
Items Number 1, 5, 11, 12, and 13 must be provided to apply
the deposit to the proper case number(s).
1.
2.
3.
4.
5.

6.
7.
8.
9.
10.

11.

12.

13.

HOC Area Identifier: (Required entry) Enter the 2-digit HOC
code (e.g., P1 for the Philadelphia Area 1).
HOC Area Name: For example: Philadelphia Area 1.
M & M's NAID: Enter the M & M's name/address identifier
(NAID).
M & M's Business Name: Enter the M & M's business name.
Form HUD-235.1 Receipt Number: (Required entry) Enter
the assigned sequential number for each transaction forwarded
to the lockbox.
Check Amount: The amount of the check that accompanies
this form.
Check Date: Enter date of check.
Check Issuer Name: The name of the organization or person
that issued the check.
Lease Number: The lease number for rent receipts.
Unit Number: The unit number for rent receipts.
Note: All checks and money orders must be either payable
to HUD or endorsed to HUD. If not, the check or money order
will be rejected and returned to the proper HUD office. The
acceptable names are:
Department of Housing and Urban Development
HUD
Federal Housing Administration
FHA
FHA Comptroller
Secretary of HUD
Housing
United States Treasury
FHA Case Number: (Required entry) The case number for all
receipts. If no specific HUD case number is associated with the
receipt, it should be applied to the HUD Office Allocate Case
Number (e.g., 131-ALLOCA for Atlanta Area 1).
Post Code: (Required entry) The post code for a specified or
allocated case number and dollar amount. A list of the most
common codes is given below.
Amount: (Required entry) The dollar amount allotted to a
specified or allocated case number and post code. If a check
contains more than one type of receipt, indicate the amount for
each application of funds.

Previous editions are obsolete

14. Property Address: The street address of the listed case
number.
15. Total Amount This Page: The total dollar amount for this page.
If multiple forms are submitted, place the total amount on page
one only. On page two and following pages, place the total for
the page in the total box and leave Check Amount box blank.
16. Preparer's Signature: Name of person who completed the form.
17. Title: Title of person who completed the form.
18. Phone No.: Phone number, with an area code, of person who
completed the form. Please provide a commercial number, not
an FTS number.
19. Date Signed: Enter the date the form was signed.
Note: Submit only the completed form SAMS-1100 with
the check or money order to the Single-Family REO
Lockbox. All other documentation should be retained in
the official Field Office files.
Allocated (Non-case specific) Post Codes
AD Advertising
AF Misc. Collection
Case Specific Post Codes
CF Condo/HOA Fees Refund
EF Earnest Money Forfeiture
EM Earnest Money
EX Sales Extension Fee
IS Insurance Refund
LQ Liquidated Damages
MC Misc. Sales Expense
MI Misc. Income
MM Property Manager Fee Refund
MR Misc. Major Repair
PP P & P Recoveries
RT Rent
TR Termite Inspection Refund
TX Tax Refund
UT Utilities/Fuel Oil Refund

Page 2 of 2

form SAMS-1100 (3/99)
ref Handbook 4310.5