STATE OF NEBRASKA

AS ACCOUNTING DIVISION

BLANK FORMS

Note: Many of these forms are in PDF format and require the use of Adobe Acrobat Reader.

Accounting Forms

Nebraska ACH Enrollment Form

Petty Cash Fund Application (updated 4-07) and Instruction

Fund Request and Instruction

Investment Authorization

Grant Updates – Email attachment form

W-9 Nebraska substitute - to be completed by vendor Updated

Nebraska W-9 – Completed by State of Nebraska

Nebraska Resale or Exempt Sale Certificate Form 13 Completed by State of Nebraska

Nebraska & Local Sales and Use Tax Authorizaton – Form 10 - use the Department of Revenue Link in General Policies 36 for Agency use only.

Request for Stop Pay/Duplicate Warrant (Excel)
and Instruction

Request for Travel by Personally Rented or Privately Owned Airplane

Request to Approve or Renew a Volunteer Program

Purchasing Card Account Information Form and Instructions

Example of Travel Authorization Form

(Word) and (PDF)

Warrant Cancellation Form (Excel) Warrant Cancellation Certification

Expense Reimbursement Document 2011-Jan (Excel)

Expense Reimbursement Document 2011-Jul/Dec and 2012l(Excel)

Payroll Forms

Bus Pass

Commuting - Monthly Employee Report “ Example”(Word)

Direct Deposit Enrollment Form

Employee Payment Transmittal Form

Employer Report of Special Wage Payments
SSA-131

Interim Direct Payment Worksheet

Interim Payroll Worksheet

Payroll Calculation Spreadsheet for 2012 (Excel)

Payroll Calculation Spreadsheet for 2011 (Excel)

Payroll Card Information Form updated 8-11-09
and Payroll Card Instruction

Payroll Certification Form and Instruction

Request for Payroll Emergency Stop Pay/Duplicate Warrant (Excel) and Instruction

Retirement Estimator –Link to Social Security Web site

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