SAMS1106 Invoice Transmittal

Single Family Acquired Asset
Management System (SAMS)

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

Invoice Transmittal

Instructions: Read Instructions on back before completing this form. Send completed the form to HUD HOC, Attn: M & M Contract GTR/GTM.

I. APTR Screen.

Create Transmittal (Items 1 thru 10)

1. System Generated Transmittal No.

2. HOC Area Identifier

4. M&M Contractor's NAID

5. M&M Contractor's Business Name

6. Payee's NAID

7. Payee's Name

8. Check Only One

3. HOC Area Name

9. No. of Invoices
8a. Start Date (mm/dd/yyyy)

10. Transmittal Total
$

Prompt Payment
Non-Prompt Payment (Will be paid within five
working days of receipt at SAMS Disbursement Contractor)
8b. Discount Date (mm/dd/yyyy)

Discount (Percent)
II. APTC Screen. Invoice Detail (Items 11 thru 18)
11. Invoice No. 12. Invoice Date

13. PO/CO/WO

14. Description

15. PC 16. FHA Case Number 17. Amount Per PC

18. Invoice Total

III. Preparer's/Reviewer's Certification (Items 19 thru 25)
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)
19. Preparer's Signature (M&M Contractor/Closing Agent/SF REO staff)

20. Title

21. Phone No. (Area Code)

22. Date (mm/dd/yyyy)

X
23. Reviewer's Signature (M&M Contract GTM)

24. Approver's Signature (M&M Contract GTR)

25. Date (mm/dd/yyyy)

X

IV. For HUD Certifying Officer's Use Only (Items 26 - 28)
Pursuant to authority vested in me, I certify this transmittal and its attachments are correct and proper for payment.
26. Authorized Certifying Officer's Signature (Not assigned to SF REO Division)

28. Certifying Officer's Stamp

27. Date (mm/dd/yyyy)

X

V. For SAMS Disbursement Contractor Use Only (Items 29 thru 32)
29. Processor's Name

Previous editions are obsolete

30. Invoice (IV) Entered By

31. Transmittal (TR) Entered By

Page 1 of 2

32. Approve Transmittal (AP) By

ref Handbook 4310.5

form SAMS-1106 (3/99)

Public reporting burden for this collection of information is estimated to average 30 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-1106 (Please use typewriter or print in ink)
1.

System Generated Transmittal No.: Enter the computer-generated
12 character Transmittal Number.

Allocated Post Codes (As of 3/99)

2.

HOC Area Identifier: Enter the HOC Area Identifier (e.g., P1 for
Philadelphia Area 1).

AD
Advertising
Case Specific Post Codes
(As of 3/99)

3.

HOC Area Name: Enter the HOC Area name (e.g., Philadelphia Area
1).

AL

Appliances

BR

MM
MR
NA
RB

13. PO/CO/WO: Enter the appropriate purchase order (PO) or formal
contract number (CO) for invoices to be applied to an established
purchase order or contract, if applicable.

MI

Board-Up/Secure,
Glass, Windows, & Lock
Changes
Clean-Up & Debris
Removal
Condo/HOA Fees
Closing Agent Fees /
Packaging Agent
Liability Claims
Defective Paint/LBP
Removal
Demolition
Earnest Money
Forfeiture
Earnest Money Refund
Evictions
Refund of Sales
Extension Fee
General Repair, Building
Supplies, Carpentry,
Masonry, & Painting
Inspection Fees
Lead Based Paint
Escrow
Misc. Income-Refunds

14. Description: Enter a brief description of the type of goods/services
rendered.

UT
WT
WN

Utilities/Fuel Oil
Water / Water Testing / Well Drilling
Winterizing

4.

M&M's NAID: Enter the Name/Address identifier.

5.

M&M's Business Name: Enter the M&M's business name.

6.

Payee's NAID: Enter the unique 10 letter/number name and address
identifier of the vendor. If this vendor has not been previously approved
by HUD, submit a completed form SAMS-1110 or -1111, as appropriate.

7.

8.

9.

CD
CF
CL

Payee's Name: Enter the name of the vendor to whom payment will be
made. The name entered on this line must be identical to the vendor's
name as it appears on the invoice.

CS
DF

Check One: Enter a check mark in the appropriate space to indicate
the type of payment method of this (these) invoices(s): Prompt Payment, non-Prompt Payment, or discount. If Prompt Payment, enter the
start date, i.e., date proper invoice is received or date services or goods
are accepted, whichever is later. If discount, enter the percent and due
date.
No. of Invoices:
transmittal.

DM
EF
EM
EV
EX

Enter the number of invoices included in this

10. Transmittal Total: Enter the Grand Total amount of the transmittal.
GN

11. Invoice No: Enter the actual invoice number shown on the vendor's
invoice, if available. The original invoice and supporting documentation specified in Handbook 4310.5 must be attached to the
SAMS-1106.

IF
LN

12. Invoice Date: Enter the date of the invoice.

15. PC: Enter the Post Code for the service provided by the vendor, e.g.,
Advertising (AD), Yard Maintenance (YR).
16.

RF
RT
SI
SL
SR

SS
SW
SY
TL
TM
TO
TP
TR
TT
TX

M&M's Fee
Misc Major Repairs
Appraisal - Non Access
Fees
Repurchase / Buy Back
Expense
Roofing
Rent Refund
Sales Incentives/
Allowance
Selling Broker Commissions/Bonus
Mechanical System
Repair - Electrical,
Heating, Air Conditioning,
& Plumbing
System Checks
Snow Removal
Surveying
Title Evidence Review
Termite Treatment
Tax Penalty - Incurred by
Others
Tax Penalty - Incurred by
HUD
Termite Inspection
Title Policy
Tax Expense/Refund

YR
Yard Maintenance
FHA Case Number: If a case specific code was entered in 15, enter
the FHA case number of the property for which goods or services were
procured.

17.

Amount per PC: Enter the total dollar amount for a specific post code.

18.

Invoice Total: Enter the total dollar amount of the invoice.

19-22. Preparer's Signature: Enter legible signature, title, phone number,
and date signed of the preparer (M&M Contractor/Closing Agent/SF
REO staff).
23.

Reviewer's Signature: Enter legible signature of the M&M Contract
GTM.

24-25. Approver's Signature: Enter legible signature and date signed of the
M&M Contract GTR.
26-28. Authorized Certifying Officer's Certification: Enter legible signature and date signed, and stamp of authorized officer, and submit to
the SAMS Disbursement Contractor.
29-32. For SAMS Disbursement Contractor's Use Only. Enter initials of
individual completing each processing step.
Previous editions are obsolete

Page 2 of 2

ref Handbook 4310.5

form SAMS-1106 (3/99)