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V1.5 9/3/2014
Credit Gateway Account Setup Form
Agency Instruction
Email completed form to CreditGateway@fiscal.treasury.gov
Allow five business days for processing new account
Account Service
Request
New Account
Change to Account
Close Account
Agency Locator Code
Agency Name
Agency Address
Agency Contacts
Name
Phone
Email
Primary Contact
Secondary Contact
Alternate Contact
Program Enrollment
ACH
Fedwire
OLBP
CIR Cash Flow Name
(25 character limit)
Fiscal Service Personnel
Authorizing Official
Credit Gateway Customer Care Personnel
Account Number
Technician
click to sign
signature
click to edit