Fillable D C P I M F U Q (FAA MMAC)

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D C P I M F U Q (FAA MMAC)

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The D C P I M F U Q (FAA MMAC) form is 1 page long and contains:

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  • 7 check-boxes
  • 15 other fields

Country of origin: US
File type: PDF

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I request a waiver from EFT for my travel payments and need to continue receiving paper checks. I have
cited my reason and provided the justification below. I understand that my first and second line supervisor
must sign off on this form, and that final determination will be made by the AMZ-1 Director for Financial
Services. Please complete all information.
Section 1: Employee Information
Employee Name (please print and sign)
___________________________________________________________________
Organization and Routing Symbol:
__________________________________________
Facility Address:
____________________________________________
Work Telephone Number: Date:
Section 2: Reason for Waiver (on page #2)
Imposes a hardship
Infrastructure in a foreign country
Disaster area
Military operation
National emergency
National security
Payment is non-recurring
Section 3: Justification for Waiver *(must provide)
Section 4: Approvals
First Line Supervisor (please print and sign)
_______________________________________
Phone Number Date
Second Line Supervisor (please print and sign)
_______________________________________
Phone Number Date
Office of Financial Management
Approve Deny Date
Title 31, Part 208, sec. 4
Payment by electronic funds transfer is not required in the following cases:
(a) Where an individual determines, in his or her sole discretion, that payment by
electronic funds transfer would impose a hardship due to a physical or mental disability or a
geographic, language, or literacy barrier, or would impose a financial hardship. In addition,
the requirement to receive payment by electronic funds transfer is automatically waived for
all individuals who do not have an account with a financial institution and who are eligible to
open an ETA\SM\ under Sec. 208.5, until such date as the Secretary determines that the
ETA\SM\ is available;
(b) Where the political, financial, or communications infrastructure in a foreign country
does not support payment by electronic funds transfer;
(c) Where the payment is to a recipient within an area designated by the President or an
authorized agency administrator as a disaster area. This waiver is limited to payments made
within 120 days after the disaster is declared;
(d) Where either:
(1) A military operation is designated by the Secretary of Defense in which uniformed
services undertake military actions against an enemy, or
(2) A call or order to, or retention on, active duty of members of the uniformed services is
made during a war or national emergency declared by the President or Congress;
(e) Where a threat may be posed to national security, the life or physical safety of any
individual may be endangered, or a law enforcement action may be compromised;
(f) Where the agency does not expect to make more than one payment to the same
recipient within a one-year period, i.e., the payment is non-recurring, and the cost of making
the payment via electronic funds transfer exceeds the cost of making the payment by check;
and
(g) Where an agency's need for goods and services is of such unusual and compelling
urgency that the Government would be seriously injured unless payment is made by a
method other than electronic funds transfer; or, where there is only one source for goods or
services and the Government would be seriously injured unless payment is made by a
method other than electronic funds transfer.
Any individual determination of a hardship due to a physical or mental disability shall
be considered solely for the purpose of waiving the EFT requirement.
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D C P I M F U Q (FAA MMAC)

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Completed 19 July 2020

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