FINANCIAL DATA FOR INTERAGENCY AGREEMENTS
Below is the specific financial data to be included in an interagency agreement (IAA) in accordance with Business
Rules for Intragovernmental Transactions – see Treasury Financial Manual Bulletin 2007-03 Volume I
(http://www.fms.treas.gov/tfm/vol1/07-03.pdf)
Requesting Agency Information (“buyer”)
Requesting Agency Name
Requesting Agency’s Agreement Number
DUNS # (Business Partner Network/BPN #)
Agency Location Code (ALC)
Trading Partner Number * (TPN)
Tax ID (Tax ID #)
Treasury Account (Fund) Symbol (TAS or TAFS)
Does TAS/TAFS include any Recovery Act funds? Yes No
Confirm the above referenced agreement does NOT involve transfer to NSF any FY 2009 Recovery Act, stimulus,
or other such specially earmarked funds.
Fiscal Year Funds Appropriated
Type of Funds (e.g., one-year, two-year, no-year)
Reimbursement basis
Billing Method through IPAC (select one)
Advance payment basis
Business Event Type Code (BETC) DISB (as requesting agency)
Contact Information: Name Address/Email/Telephone
Finance Office (billing)
Contract/Grants Officer
(obligating official)
Program Official
Agency Official
completing this form:
Printed Name Signature / Date
* Trading Partner Number is typically the first two digits of the ALC except for DOD agencies
NSF’s Administrative Recovery Rate for FY 2010: 4.95% deducted from total funds transferred
Revised: January 5, 2010 (NSF Form 1611)