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G-INVOICING AGENCY ACCOUNT CHANGE FORM 

This form should be used to request changes to an existing G‐Invoicing agency account; update agency or shared service

provider, add or edit ALC/TAS data or update the Primary Master Administrator (formerly Disburser Administrator).

The change request form must be submitted with the required approvals; if the form does not have the appropriate approval

signatures the form will be returned.

Please allow a minimum of 5 business daysfor the requested changesto be completed. Please only complete the sections to

be updated, all other sections should be left blank.

Once completed, the “Primary Master Administrator” and/or “Agency Approver” signs and submits to STLS G‐Inv Treasury

Support Center GInvoicing@STLS.frb.org. If there are any questions, please feel free to contact the STLS G‐Inv Treasury

Support Center via email, GInvoicing@STLS.frb.org the G‐Invoicing Agency Implementation representative via email or the

Treasury Support Center at (877) 440‐ 9476.

Agency Contact Information

*Agency Account Name:

*Full Name:

*Title/Position:

*Phone Number:

*Email Address:

*Requested Change Date:

* Required information

Select change being requested:

I. Agency Account

☐ Complete the “Agency Account” section.

☐ Primary Master Administrator or Agency Approver signs the form.

II. Agency Locator Code (ALC) or Treasury Account Symbol (TAS)

☐ Complete the “Agency Locator Code (ALC) Treasury Account Symbol (TAS) Change LC/TAS” section.

☐ Primary Master Administrator or Agency Approver signs the form

III. Shared Service Provider

☐ Complete the Agency Account Information section.

☐ Primary Master Administrator or Agency Approver has signed form.

IV. Master Administrator

☐ Complete the Master Administrator section.

☐ Primary Master Administrator or Agency Approver has signed form.

I. Agency Account Change

G‐Invoicing Agency Account Information

*Agency Name:

*Address:

*City:

*State/Province:

*ZIP Code:

*Country:

*Phone Number:

* Required information
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II. Agency Locator Code (ALC) Treasury Account Symbol (TAS) Change

ALC and TAS Information

*Agency Location Code(s)

If additional ALC& TASs are needed,

please provide a separate document

Treasury Account Symbol (TAS) Account Filters:

Using an * in the table will include all data for that field, if more granular accessis needed please specify in the

fields column. Each row is a separate TAS filter. For TAS filters, use the additional rows provided.

ATA *AID MAIN SUB

 

III. Shared Service Provider

G‐Invoicing Share Service Provider Change

*Shared Service Provider name:

* Full Name:

Title/Position:

*Email Address:

*Phone Number:

*Address 1:

*Address 2:

*City, State:

*Zip Code:

Description of Change:

* Required information

IV. “Primary” Master Administrator or “Master Administrator” Change

 The “Primary Master Administrator” or “Agency Approver” can request a “Master Administrator” be added or removed

to the agency account.

 The “Primary Master Administrator” must be “active” in G‐Invoicing to approve adding a new “Master Administrator”.

 If the “Primary Master Administrator” is not “active” an “Agency Approver” may submit the change request to add

another “Master Administrator”.

 There can only be one “Primary Master Administrator” identified at one time, all other “Master Administrators” are

secondary.

 A new “Primary Master Administrator” must also acknowledge and sign the “G‐ Invoicing Primary Master Administrator

Acknowledgment” section below.

 A new “Master Administrator” must also acknowledge and sign the “G‐Invoicing Master Administrator

Acknowledgment” section below.

Update “Primary” Master Administrator

☐ SailPoint IIQ “AppApprover” **

*Name:

*Title/Position:

*Email Address:

*Phone Number:

New PMA Signature:

Digitalsignature (PIV,PIV‐I,CAC)
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User Information

(if adding additional Master Admins or

SailPoint "AppApprovers")

Master

Administrator

SailPoint

“AppApprover” **Digital Signature

of user being added

(PIV, PIV‐I, CAC)

Name Email Address

ADD Remove* ADD Remove*

QA Prod QA Prod QA Prod QA Prod

‐ Do not lock form after signing to allow multiple signatures.

‐ If additional “Master Administrators” are needed, please provide a separate document. The “Primary Master Administrator” will be added as

the “User Administrator” for all “Master Administrator” user accounts in G‐Invoicing by default.

‐ The “User Administrator” can be updated once the account has been established.

*No signature needed to Remove Master Administrators or SailPoint “AppApprovers”

**All Master Administrators and “AppApprovers” being added must digitally sign the form to indicate they have read and agree to the

“AppApprover” Responsibility Agreement below. Do not lock form after signing to allow multiple signatures.

Responsibilities:

SailPoint “AppApprover” Responsibilities:

I am aware that the Bureau of the Fiscal Service’s policy is to treat all information as an asset, whether it is computer programs,

software, data or otherinformation collected,stored, and generated in the conduct ofits business. To the best ofmy ability, Iwill protect

information from unauthorized use, modification, destruction, or disclosure, whether accidental or intentional.

o I am aware of the policies and requirements of the Bureau of the Fiscal Service and agree to abide by them.

o I will NOT attempt to circumvent any of the security mechanisms within SailPoint IdentityIQ and GINV system.

o I will ensure that proper authorizations on requests are checked.

o I will ensure that all fields on the requests are complete and correct.

o I will ensure properrecord keeping of all information processed.

o I will comply with allsecurity‐related polices,standards, procedures and practices.

o I will notify the Treasury Support Center at 877‐440‐9476 of any known orsuspected violation of information security policy,

procedures, or threat to IPAC resources.

I have read and understand the “AppApprover” Responsibility Agreement and agree to abide by it.
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V. G‐Invoicing “Primary” Master Administrator Acknowledgment

“Primary” Master Administrator agrees:

 Retain the signed copy ofthe G‐Invoicing System Account Enrollment Form for a period ofseven (7) years and

make it available for examination by request.

 Ensure two (2) Master Administrators are assigned AND active in the agency account at all times.

 Ensure all G‐Invoicing users are informed of the requirements listed below:

1. Users must certify that Intragovernmental transactions (IGT) are in compliance with the

requirements and responsibilitiesset forth in applicable laws and regulations, including Vol. 1 Treasury

Financial Manual 2‐4700, App. 8, IGT Guide and related guidance on

https://www.fiscal.treasury.gov/index.html and Chapter 4000 Intragovernmental transaction

applications: Intra‐governmental payment and collections(IPAC) andGovernment Invoicing (G‐ 

Invoicing).

2. Usersshall not decompile, disassemble or reverse engineer any aspect of G‐Invoicing

3. Use ofG‐Invoicing is only for processing transactionsfor any aspect oftheUnited States

government;

4. Usersshall not reproduce, duplicate, copy,sell,resell, or exploitfor any commercialpurpose, any

portion of G‐Invoicing;

5. Usersmust agree thatG‐Invoicing may contain proprietary information of a third party for which

the Federal Reserve Bank has obtained a license for use and disclosure;

6. Accessto G‐Invoicing is granted based on least privilege access model and individual

credentials assigned to each individual user of the system:

a. Usermust not divulge credentials used toaccessthe system to anyone.

b. Usermust notshare credentialswithany other users.

c. Unauthorized use may resultin prosecution or criminal penalties. If Isuspect that the

confidentiality of my credentials has been compromised, I will immediately notify the

Treasury Support Center at (877) 440‐ 9476.

Additionally,theG‐Invoicing PrimaryMasterAdministrator acknowledgesthe following terms and will

ensure Master Administrators and User Administrators are informed and aware of the following

requirements.

“Master Administrator” and “User Administrator” certifies:

1. Create and maintain users who are authorized to conduct G‐Invoicing transactionsfor the agency.

2. Apply least privilege access requiring users be granted the most restrictive set of privileges required

to perform the duties of their role and responsibilitiesthereby limiting the potential damage that can

result from accident, error, or unauthorized use.

(Note: ALL Master Administrators and User Administrators should reference the “G‐Invoicing Administrator” and “G‐ 

Invoicing User Guide” for a list of application roles and permissions.

The guides are available on the G‐Invoicing Home Page.)

3. Ensureuser accounts are disabled within two (2) business daysof voluntarily leaving service.

4. Ensure user accounts are disabled immediately (same day) when a user isinvoluntarily

terminated from service.

5. Participate in G‐Invoicing “Annual User Recertification” to review and approve user access of the G‐ 

Invoicing agency account and confirm access is appropriate for their role and responsibilities

within the agency.
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VI. Approval Signatures

“Primary” Master Administrator Signature

*Name:

*Title:

*Date:

Signature:

Digitalsignature (PIV,PIV‐I,CAC)

Agency Approver Signature (required only for “Primary” Master Administrator assignment)

*Approver Name:

*Approver Title (required):

*Email Address:

*Phone Number:

*Address:

(Street, City, State, Zip)

*Date:

*Agency Approver Signature:

Digitalsignature (PIV,PIV‐I,CAC)

* Required information

By signing as an Agency Approver, the officer (Chief Financial Officer, Comptroller, Deputy

Financial Officer, Director of the Office of Finance, Office of Accounting or other

comparable title) or Agency Master Administrator certifies that he/she is duly authorized by

the agency/organization to designate who may serve as “Primary Master Administrator”

for the above‐named agency.

The following section will be completed by the Federal Reserve Bank of St. Louis

Agency Change entered in G‐Invoicing by:

Environment: Quality Assurance (QA‐C) Production

Name: 

Date: 

Signatures:

Digitalsignature (PIV,PIV‐I,CAC)

 

11.5.5.1 Write and Maintain a Privacy Act Statement

Pursuant to 5 U.S.C. §552a (e) (3) agencies are required to provide what is commonly referred to as a Privacy Act Statement to all persons asked 

to provide personal information about themselves, which will go into a system of records (i.e., the information will be stored and retrieved using 

the individual’s name or other personal identifier such as a Social Security Number). Department of the Treasury (Treasury) policy is to provide a 

Privacy Act Statement regardless of whether the collection is part of a system of records or not. All Privacy Act statements must be reviewed by 

the Chief Privacy Officer or Privacy Act Officer.