Date:April 16, 2008
Bulletin Number: 814

Additional Requirement for Submitting Form AC 1476-P (Report of Check Exchange)


To notify agencies of the additional requirement of the employee’s death certificate when submitting Form AC 1476-P (Report of Check Exchange) for the reason of “Death of Payee.”

Affected Employees

Beneficiaries of deceased New York State employees.

Effective Date(s)



Instructions for the Form AC 1476-P (Report of Check Exchange) have been revised to accommodate additional required documentation as advised by OSC’s Legal Services.

Agency Actions

Agencies are now required to provide a copy of the employee’s death certificate.

Note:  The Social Security or Taxpayer Identification number(s) for the estate or the beneficiary of the deceased employee in addition to the address(es) of the recipient(s) must be included on the form.

Form AC 1476-P is to be used for payroll transactions only.

Click here to access AC 1476-P form available on the OSC website.  Agencies may contact OSC's Office Services by telephone at 518-474-3438 or by fax at 518-473-4560 to request a supply of the form.


Questions regarding salary may be directed to the Salary Determination mailbox.