DEPARTMENT OF HOMELAND SECURITY United States Secret Service
DISPOSITION (For Secret Service Use Only) Genuine note and SSF 1604 returned to bank (Receipt No. ) SSF 1604 (Rev. 09/2015) Page 1 of 1 WAS THERE ANY SUSPICIOUS ACTIVITY? IS THIS A NON - CUSTOMER? Yes Yes No No DATE OF ACTIVITY OR DEPOSIT DEPARTMENT OF HOMELAND SECURITY United States Secret Service COUNTERFEIT NOTE REPORT NAME OF BANK: ................
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