Name / Title:

Agency Name:

E-mail Address / Telephone #:

Signature:

FS Org Name (Bureau):

Date of Request:

o Discontinue

3. Treasury Account Information:

4. Business Justification (Reason for Request; Additional Information as needed):

5. For Allocation Accounts Only (Must have concurrence from both the parent and child agencies):

Department of the Treasury | Bureau of the Fiscal Service Revised January 2023

BUREAU OF THE FISCAL SERVICE

FISCAL ACCOUNTING

TREASURY ACCOUNT ACTION REQUEST

Questions/Comments; Email: baasgroup@fiscal.treasury.gov

2. Requesting Agency Information:

Parent Agency:

o Reactivate

*May require

legal opinion

Account Type: 

Borrowing

Authority: 

Agency responsible for the reporting: o Parent o Child

Child Agency:

SP: ATA: AID: BPOA: EPOA: A: MAIN: SUB:

Account Title:

Specific Legal Authority:

Account Title:

Specific Legal Authority:

Account Title:

Specific Legal Authority:

Account Title:

Specific Legal Authority:

Fiscal Service Use Only

Indefinite: Distributed:

Agency Contact:

Approval:

Agency Contact:

Approval:

o

**IMPORTANT** - SECTIONS 1 THROUGH 4 ARE MANDATORY

1. Action Requested for TAS/TAFS: Suspend/Unsuspend

FS Form 000109

(Choose ONLY ONE option per request)

o Establish
BUREAU OF THE FISCAL SERVICE

FISCAL ACCOUNTING

TREASURY ACCOUNT ACTION REQUEST

INSTRUCTIONS PAGE

Insert date the Agency is preparing the request

1. Select ONLY ONE action:

• "Establish" will create a new Treasury Account that does not currently exist

• "Suspend/Unsuspend" will either suspend a Treasury Account that is currently active or unsuspend a Treasury Account that is

currently suspended (please indicate which is appropriate in item #4)

• "Discontinue" will close a Treasury Account that is currently active

• "Reactivate" will open a Treasury Account that was previously closed which may require a legal opinion from the agency's

general counsel

2. Provide Agency and contact information for the person signing the form, thereby authorizing the request:

• "Establish" will typically require a supervisor/manager level who has direct or delegated authority to perform this

function.

• "Suspend" will typically require a supervisor/manager level who has direct or delegated authority to perform this

function.

• "Discontinue" will typically require a supervisor/manager level who has direct or delegated authority to perform this

function, however no-year "X" appropriation accounts require a require signature by the head of agency or (if so delegated the

authority to perform this function, the CFO, Director, or equivalent officer).

• "Reactivate" could be a supervisor/manager level who has direct or delegated authority to perform this function, however the

legal circumstances could require it to be a higher level

• Requestor, who has direct/delegated authority, certifies (under penalty of perjury, in accordance with 28 U.S.C. 1746) that:

o its submission complies with the requirements and responsibilities set forth in applicable laws and regulations,

including Circular No. A–11 Preparation, Submission, and Execution of the Budget, (8/21), Treasury Financial Manual

(TFM) Volume 1, Part 2, Chapter 2000, and TFM Volume 1, Part 2, Chapter 4200 (Section 4245).

o for account closures pursuant to 31 U.S.C. § 1555, the authorized official has determined that: (1) the purpose of the

appropriation has been carried out; and (2) that no disbursement has been made against the appropriation for the last

two consecutive fiscal years.

• At its discretion, Fiscal Service may require the requestor to provide additional information to determine compliance with the

requirements above.

3. Provide the Treasury Account Information:

• "SP" - Sub-level Prefix (very rare, normally blank)

• "ATA" - Allocation Transfer Account (for allocation accounts ONLY: Provide the 3-digit AID for the child agency)

• "AID" - Agency Identification code (must be three digits)

• "BPOA" "EPOA" - Beginning and Ending Periods of Availability (blank for "X" or "F" accounts)

• "A" - Availability code (blank for accounts with a POA, otherwise either "X" for indefinite period of availability or "F" for

clearing accounts)

• "MAIN" - The 4-digit main account for the program

• "SUB" - 3-digit point identification (default is 000 unless otherwise specified)

• "Account Type" - Select proper account type from dropdown menu

• "Borrowing Authority" - Select proper borrowing authority from dropdown menu (if no borrowing authority exists, select

"None")

• "Account Title" - Generally derived from the specific legal authority, however it could be derived from either Treasury or OMB

guidance

• "Specific Legal Authority" - Specific enacted legislation authorizing the requested action (either U.S. Code or Public Law with

Statute "STAT" page)

• Note: If more than four Treasury Accounts are needed for a particular request, please fill out a separate form or contact the

BAAS group for an exception

4. Provide the business justification/reason for the requested action and any additional information as necessary to support the

request (Note: If requesting discontinuance of a no-year appropriation account, the two criteria in 31 USC 1555 must be asserted

in this part of the request)

5. For Allocation Accounts ONLY.

• Identify which agency (either the Parent or the Child) will be responsible for the reporting

• Provide the Parent Agency, contact name, and approval (typically will be a supervisor/manager level)

• Provide the Child Agency, contact name, and approval (typically will be a supervisor/manager level)