| REF |
NAME |
LENGTH
/TYPE |
DESCRIPTION |
| 1. |
Originating Agency Code |
5 N |
Identification code
of the agency preparing the batch. Reference Accounting
Codes Manual Vol. VIII |
| 2. |
Batch Number |
6 N |
Sequential identification
number assigned to batch by the originating agency. |
| 3. |
Batch Type |
3 AN |
Always RFD
when agency keys document. REF when keyed by
OSC. |
| 4. |
Number of Documents |
3 N |
The number of documents
in the batch. |
| 5. |
Net Amount |
18 N |
The sum of the amounts
of the documents in the batch. |
| 6. |
Voucher No. |
7 AN |
The alpha/numeric
(A/N) identification number of the original voucher to which
the refund applies or next available number from agency's
Document Register.
( Required) |
| 7. |
Originating Agency |
-------- |
The name of the
agency preparing the document and batch transmittal. ( Required) |
| 8. |
Orig. Agency Code |
5 N |
Identification code
of the agency preparing the document and the batch.
Reference Accounting Codes Manual for agency codes.
(Required) |
| 9. |
P-Contract |
6 AN |
The P contract number
of the original payment, if any. (Required - when applicable) |
| 10. |
Payment Date |
6 N |
The month, day and
year the original payment was made. (Required) |
| 11. |
OSC Use Only |
---------- |
DO NOT COMPLETE
THIS FIELD. |
| 12. |
Liability Date |
6 N |
The liability date
contained in the original payment voucher representing the
month, day and year the goods were received or services
were preformed, or the ending date of the liability period.
(Required) |
| 13. |
Payee ID Additional |
9 N
5 N |
The Payee ID number
and additional ( if applicable) from the original voucher.
If the payee is listed on the Payee Name and Address File,
this field also includes the required five character
Payee Additional as assigned by New York State. For 3rd
Party Recoveries use Payee ID 14-6013200 or leave these
fields blank. |
| 14. |
Zip Code |
9 N |
Postal Zip Code
of payee, used as a verification number against the Payee
Name an Address File. ( Required) |
| 15. |
Payee Amount Refunded |
18 N |
The TOTAL
dollar value of the transactions on the document.
Included commas and decimals. This field, plus all
payee amounts from any Payee Continuation document
(AC2395), must agree with the total of field #35 and
batch total. (Required) |
| 16. |
Payee Name |
30 AN |
The payee's name
as it appeared on the original voucher. (Required
) For 3rd party Recoveries use payee name "New
York State". |
| 17. |
Payee Name |
30 AN |
If needed, continuation
of Payee Name. |
| 18. |
Address |
30 AN |
Payee's street address
as it appeared on the original voucher. (Required) |
| 19. |
Address |
30 AN |
If needed, continuation
of payee's street address. |
| 20. |
City |
20 AN |
Name of the city
of the payee's address, from the original voucher. (Required) |
| 21. |
State |
2 AN |
Standard postal
abbreviation of the name of the state of the payee's address,
from the original voucher. (Required) |
| 22. |
Zip Code |
9 N |
Postal zip code
in the payee's address. This must be left justified.
(Required) |
| 23. |
IRS Code |
1 AN |
A (A/N) letter code
which indicates the type of non-employee payment.
Codes are found in Section 3.1240 and 3.1245 Accounting
Codes Manual. (Required when applicable |
| 24. |
IRS Amount |
18 N |
Amount for certain
types of IRS reporting as defined by OSC. Used in
conjunction with specially assigned IRS Codes. (Required
- when applicable) |
| 25. |
Statistic Type |
1 AN |
A (A/N) codes which
indicates information chosen to be accumulated. Reference
Sections 3.1220 Accounting Codes Manual. Required
for refunds credited to federal fund appropriations. |
| 26. |
Statistic |
5 N |
The quantity of
the Statistic Type accumulated. |
| 27. |
Indicator - Dept |
5 N |
Identifies payment
data in departmental defined categories. |
| 28. |
Indicator - Statewide |
5 N |
Identifies payment
data in Statewide defined categories. |
| 29. |
Fund Name
Fund Code |
5 AN |
Fund name and fund
codes that the money applies to. Reference Accounting
Codes Manual for fund name and number. ( Required) |
| 30. |
Amount |
18 N |
The amount to be
credited to the specific fund. (Required) |
| 31. |
Check #, Amount and Basis for
request |
---------- |
The check number,
amount and source of refund and the reason for the
requested refund. (Required) |
| 32. |
Authorized signature |
------------ |
The authorized signature
of the Agency Finance Officer or agency designee.
(Required) |
| 33. |
Date |
|
The date the document
was signed by the Agency Finance Officer or designee.
(Required) |
| 34. |
Telephone No. |
|
Contact number of
the Agency Finance Officer or designee. (Required) |
| 35. |
OSC Review |
|
FOR OSC USE ONLY.
Place for the signature and date of the OSC reviewer. (Required) |
| 36. |
Account Number |
|
TREASURY INFORMATION.
The account number for the bank account in which the check
will be deposited. (Required) |
| 37. |
Dept
Cost Center
Var
Yr |
2 N
6 N
2 AN
2 N |
The dept., cost
center, variable and year combination must be the same as
appeared on the voucher(s) which generated the expenditure
now being refunded. This appropriation must be active
(not-lapsed). (Required) |
| 38. |
Object |
5 AN |
The (A/N) code indicating
the object of expense. The object code will be taken
from the original voucher. (Required) |
| 39. |
Accum |
3 AN
3 AN |
A field which accumulates
amounts in users defined categories. This field is
split into two parts of three characters each. The
firs three Characters are department assigned and used for
department accumulations; the last three are OSC assigned
and used for Statewide accumulation. |
| 40. |
Amount |
18 N |
The dollars being
refunded to one, or more, appropriations. The total
of these amounts must equal the amount in filed #15. (Required) |
|
|
|
|
| 41. |
Orig. Agency |
5 N |
The identification
code of the agency. All five digits must be entered.
(Required if REF #37 is filled in) |
| 42. |
Contract |
7 AN |
The number of the
Contract to which the original payment applied. This
information is found on the original voucher, if the voucher
applied to a contract purchase. (Required - when applicable) |