There are circumstances, such as death or incarceration, when a State Supplementary Payment (SSP) benefit is issued for which the individual is ineligible. Individuals and representative payees should return these payment checks to the County Assistance Office (CAO).
The CAO may accept personal checks, money orders or the original Treasury-issued check for the return. The CAO cannot accept cash payments.
The Receipt of State Supplementary Payment (SSP) form (PA 1797) must be completed to meet the SSP return requirements for both the Office of Budget, Comptroller Operations and the Treasury department. This form eliminates the need for CAOs to submit different forms to each department. The CAO must submit the completed PA 1797 with each SSP returned check to the applicable department listed below. If the check being returned was issued as an OTI rather than a recurring benefit, record the Reason Code for the OTI on the PA 1797.
SSPs returned by personal check or money order must be sent to the Office of Budget, Comptroller Operations. Send the completed form along with the payment check to:
Bureau of Accounting & Financial Management
General Accounting | Revenue & Cash Management
Pennsylvania Office of the Budget | Office of Comptroller Operations
555 Walnut St., 9th Floor | Harrisburg, PA 17101-1925
Returns of original Treasury-issued checks must be sent to Treasury. Send the completed form along with the original Treasury check to:
Commonwealth of Pennsylvania
Department of Treasury
SSP Disbursements
P.O. Box 8001
Harrisburg, PA 17105-8001
A copy of the form should be retained in the case record. Individuals that return an SSP check to the CAO may be provided a copy of the completed form as receipt of the return.
CAOs may print the form as needed from OIM Online Forms/Docushare.
Issued November 14, 2017, replacing May 20, 2014