Name / Title:

Agency Name:

Signature:

FS Org Name (Bureau):

Date of Request:

3. Treasury Account Symbol Title or Bureau Amendment Requests ONLY:

5. Business Justification (Purpose; Additional Information as needed):

Department of the Treasury | Bureau of the Fiscal Service Revised January 2024

BUREAU OF THE FISCAL SERVICE

FISCAL ACCOUNTING

TREASURY ACCOUNT AMENDMENT REQUEST

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

1. Action Requested (Choose ONLY ONE):

2. Requesting Agency Information:

o Amend Account Title or Bureau o Extended Disbursing Authority (EDA)

E-mail Address / Telephone #:

Specific Legal Authority:

Specific Legal Authority:

FS Form 000110

Disbursing Authority

Extended through:

YYYY

YYYY

Old Account Title:

Old FS Org/Bureau:

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

Specific Legal Authority:

New Account Title:

New FS Org/Bureau:

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

Specific Legal Authority:

Old Account Title:

Old FS Org/Bureau:

4. Extended Disbursing Authority (EDA) Actions ONLY:

New Account Title:

New FS Org/Bureau:

(1)

(2)

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

(1)

(2)
BUREAU OF THE FISCAL SERVICE

FISCAL ACCOUNTING

TREASURY ACCOUNT AMENDMENT REQUEST

INSTRUCTIONS PAGE

Insert date the Agency is preparing the request

1. Select ONLY ONE action:

• "Amend Account Title or Bureau" is used to request a change to an account title, to change the name of a Bureau, or to move

Treasury Accounts from one Bureau to another Bureau (Note: If this option is selected, only items 2, 3, and 5 are required to be

completed)

• "Extended Disbursing Authority (EDA)" is used to add or amend an EDA date for a specific Treasury Account (Note: If this

option is selected, only items 2, 4, and 5 are required to be completed)

2. Provide Agency and contact information for the person signing the form, thereby authorizing the request. Both options on this

form can typically be signed at a supervisor/manager level.

3. Provide the Treasury Account Information for account title or Bureau amendments ONLY:

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

• "ATA" - Allocation Transfer Account (for allocation accounts ONLY)(when needed, 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)

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

Statute "STAT" page)

• "Old Account Title" - Provide the account title as it exists currently

• "New Account Title" - Provide the proposed account title

• "Old FS Org/Bureau" - Provide the Bureau name as it exists currently

• "New FS Org/Bureau" - Provide the proposed Bureau name (or the Bureau name that the listed Treasury Accounts will be

moving to)

• Note: If more than two 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 Treasury Account Information for Extended Disbursing Authority requests ONLY:

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

• "ATA" - Allocation Transfer Account (for allocation accounts ONLY)(when needed, 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)

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

Statute "STAT" page)

• "Disbursing Authority Extended Through" - Provide the 4-digit fiscal year that the disbursing authority is being extended

through

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

BAAS group for an exception

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

request