---
kind: "section"
citation: "42 C.F.R. § 455.19"
title: "42"
number: "455.19"
heading: "Provider's statement on check."
url: "https://uscodex.org/cfr/42/455.19"
---

# §455.19. Provider's statement on check.


As an alternative to the statements required in [§ 455.18](/cfr/42/455.18.md), the agency may print the following wording above the claimant's endorsement on the reverse of checks or warrants payable to each provider: “I understand in endorsing or depositing this check that payment will be from Federal and State funds and that any falsification, or concealment of a material fact, may be prosecuted under Federal and State laws.”


## Notes

### Authority

Authority: 42 U.S.C. 1302.

### Source

Source: 43 FR 45262, Sept. 29, 1978, unless otherwise noted.