Forms for State Agencies and Employees

Accounting

AC 22‑S – Journal Voucher (Excel)
AC 909‑S – Report of Moneys Received (Excel)
AC 1286‑S – Refund of Appropriation (Excel)
AC 3286‑P – Federal Grant Pre-Award Information for SFS (Fillable PDF)
AC 3312‑S – AR Deposit Form (Excel)
AC 3329‑S – Cash Advance Account Confirmation & Reconciliation Form (Fillable PDF)
AC 3377 – Agency Fund Request (Fillable)

Contracts

AC 340-S
- Contract Encumbrance Request (SFS) (Excel) (Fillable PDF)
- Original AC 340 with revisions highlighted and fields defined (PDF)
AC 1782‑S – Bureau of Contracts Authorized Signature Form (Fillable PDF)
AC 3268‑S – Simplified Renewal Agreement (Word)
AC 3269‑S – State of New York Multi-Year Agreement (Word)
AC 3270‑S – Competitive Grants Procurement Record Checklist (Word)
AC 3271‑S – New York State Consultant Services Contractor's Planned Employment (Word)
AC 3272‑S – New York State Consultant Services Contractor's Annual Employment Report (Word) (PDF)
AC 3273‑S – Vendor Responsibility Profile (Word) (PDF)
AC 3276‑S
- Novation Agreement Template (All Parties) (Word)
- Novation Agreement Template (No Transferor) (Word)
AC 3277‑S – Contract Certification Form for Quick Contract Processing (Fillable PDF)
AC 3278‑S – Quick Contract Boilerplate Agreement (Word)
AC 3279‑S – Checklist for Legislative Initiative (Word)
AC 3280‑S – Request for Exception to OSC Encumbrance Policy For Programs with Multiple Grant Awards (Word) (PDF)
AC 3281‑S – Governmental Entity Representation Concerning Compliance with State Finance Law §§139-j and 139-k (Fillable) (PDF)
AC 3347 – Electronic Documents Submission System Hosting Access form (Fillable) (PDF)
AC 3357 – Online Services Bureau of Contracts Applications Account Maintenance (Fillable PDF)
AC 3358 – Online Services Government Account Authorization (Fillable PDF)

Payroll

See below for instructions for completing fillable and Excel version forms.

AC 873 – Extra Service Payroll Voucher (Fillable PDF)
AC 934-P – Next of Kin Affidavit for Bureau of State Payroll Services (Fillable PDF) (PDF)
AC 1394 – Application & Account for Partial Payment of Salary (PDF)
AC 1476-P – Report of Check Exchange (Fillable PDF)
AC 1588 – Dual Employment/Extra Service Approval Form (Fillable PDF)
AC-1767 – Suspense Waiver Request Form (Fillable PDF)
AC-1781 – Suspense Refund Request Form (Fillable PDF)
AC 2674 – W-2 Correction Worksheet (Fillable PDF)
AC 2714 – Undeliverable Payroll Check Report (Word) (Fillable PDF)
AC 2822 – Bureau of State Payroll Services Payroll Transaction Authorization Form (Fillable PDF)
AC 3173 – Agency Report of Taxable Value of Personal Use of an Employer-Provided Vehicle (Fillable PDF)
AC 3197 – Fax Request for Direct Deposit Stop/Reversal (Fillable PDF)
AC 3202 – Payroll Certification Form (Fillable PDF)
AC 3206 – Prior Year Social Security and Medicare Tax Refund Certification - CUNY (Fillable PDF) (PDF)
AC 3206 – Prior Year Social Security and Medicare Tax Refund Certification - NYS (Fillable PDF)
AC 3300-S – Certification for Payment of Pre-Adjudicatory Settlement Agreements (Fillable PDF)
Direct Deposit Form and Information (Fillable PDF)
- AC 2772 – Direct Deposit Form
- Guide to Completing AC 2772 Direct Deposit Form
Personal Privacy Protection Law Release Forms and Instructions
- Personal Privacy Protection Law Release Form Instructions
- Personal Privacy Protection Law Release Form – AC 3216
Position Data Request Forms
- Extra Service Position Data Request Form – AC 3217 (Fillable PDF) (Excel)
- NYS Position Data Request Form – AC 3218 (Fillable PDF)
- Position Data Request Form – AC 3219 (Fillable PDF) (Excel)
SUNY Charitable Giving Campaign Form
- SUNY Charitable Giving Campaign Payroll Deduction Form

Fillable PDF

To view, complete and print the fillable forms, you will need the Adobe Acrobat Reader software installed on your computer. This software does not allow you to save your completed or partially completed form to a disk or on your computer.

After opening the form, position the hand pointer inside a field and click. The I-beam pointer allows you to type text.
To go to the next field, press Tab or use your mouse to click on the next field.
To go to a previous field, press Shift + Tab or use your mouse to click on the previous field.
After completing the form, print the fillable form.

Excel

The form should be saved to the user's computer for completion and then submitted as instructed.

Purchasing and Payments

AC 92 – Standard Voucher (PDF) (Word template)
AC 130‑S – Purchase Order (Stand-alone) (PDF)
- Original AC 130 with revisions highlighted and fields defined (PDF)
- Terms and Conditions (PDF)
AC 852‑S – Business Unit Voucher Authorizer Designation (Fillable PDF)
AC 902‑S – Purchase Order Change Notice (SFS) (Fillable PDF)
- Original AC 902 with revisions highlighted and fields defined (PDF)
AC 946 – Tax Exempt Certificate (Fillable PDF)
AC 1171 – State Aid Voucher (PDF)
AC 1366‑S – Land Claims Payment Voucher (SFS) (Fillable PDF)
- Fields numbered and defined (PDF)
AC 2397 – Voucher Charge Continuation with Tail (Fillable PDF)
AC 3253‑S – Claim for Payment (Fillable PDF) (with auto-calculate)
- Instructions for Users (PDF)
- Fields numbered and defined (PDF)
AC 3254‑S – PeopleSoft Charge Continuation (Fillable PDF)
- Instructions for Users (PDF)
- Fields numbered and defined (PDF)
TD- 346 – Request for Stop Payment, Replacement Check, Photocopy of Check or Forgery Affidavit (Fillable PDF)

Travel

AC 132‑A – Travel Voucher (Form AC 132-A is now obsolete and has been replaced by form AC 132-S)
AC 132‑S – Employee Report of Travel Expenses and Claim for Payment (Fillable PDF) (Fillable Word)
- Fields numbered and defined (PDF)
AC 160‑S – Statement of Automobile Travel (Fillable PDF) (Fillable Word)
- Fields numbered and defined (PDF)
AC 1099‑S – Request/Agreement for Moving Expense Reimbursement (Fillable PDF)
- Fields numbered and defined (PDF)
AC 3256‑S – Statement of State Corporate Travel Card Charges (Fillable PDF) (Fillable Word)
- Fields numbered and defined (PDF)
AC 3257‑S – Claim for Travel Reimbursement by a Non-Employee (Fillable PDF) (Fillable Word)
- Fields numbered and defined (PDF)
AC 3258‑S – Statement of Meals Claimed (Fillable PDF) (Fillable Word)
- Fields numbered and defined (PDF)
AC 3259‑S – Statement of Incidental and Transportation Expenses (previously on AC 148) (Fillable PDF) (Fillable Word)
- Fields numbered and defined (PDF)

Vendors

AC 3237‑S – New York State Substitute Form W-9 (Fillable PDF)
AC 3261‑S – Special Use Vendor ID Request (Fillable PDF)
AC 3266‑S – Single Payment Vendor ID Request (Fillable PDF)
AC 3267‑S – Foreign Vendor Registration Request (Fillable PDF)
AC 3317 – Customer ID Request Form (Fillable PDF)

Other

AC 934 – Next of Kin Affidavit (Fillable PDF)
AC 1551 – Affidavit to Support Claim of Forged Endorsement (Fillable PDF)
AC 3300‑S – Certification for Payment of Pre-Adjudicatory Settlement Agreements (Fillable PDF)
AC 3337 – Request for Check Copy or Forgery Claim for the Comptroller's Refund Account (P and W Checks) (Fillable PDF)

Forms for State Agencies and Employees

Accounting

Contracts

Payroll

Payroll

Fillable PDF

Excel

Purchasing and Payments

Travel

Vendors

Other

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