Fillable Expressing Billing Form (U.S. Office of Personnel Management)

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Expressing Billing Form (U.S. Office of Personnel Management)

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The Expressing Billing Form (U.S. Office of Personnel Management) form is 3 pages long and contains:

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Page 1 of 3
PRESIDENTIAL RANK AWARD (PRA) EXPRESS BILLING
INSTRUCTIONS TO COMPLETE PRESIDENTIAL RANK AWARD (PRA) EXPRESS BILLING FORM
1. This Express Billing Form is a financial obligating document and must be signed by a finance officer. This obligates payment
for all nominees submitted to OPM for consideration for the 2012 Presidential Rank Award (PRA) Program. However,
agencies will only be invoiced for the number of PRA nominees selected as finalists who are submitted for on-site
evaluations and criminal history name checks.
2. All information must be provided for record keeping purposes.
3. A separate Express Billing Form must be completed for each combination of an Agency Location Code (ALC) and Treasury
Account Symbol (TAS).
4. An Express Billing Form can only represent obligation for one combination of ALC and TAS.
5. All nominee names from an Agency/Division must be listed on the Express Billing Form dedicated to their own ALC and TAS
combination.
6. Each agency will receive a separate invoice from OPM for each Express Billing Form.
7. An obligating document (P.O.) must accompany each Express Billing Form unless a Government Purchase Card is used.
PRESIDENTIAL RANK AWARD (PRA) EXPRESS BILLING
Requesting Agency Name: Date:
Agency Division Name:
Select Payment Method:
IPAC
Government Purchase Card (GPC)
Total Number of Nominees Submitted
x $ 550.00 Cost Per Nominee
= Total Obligation
To Be Completed By Requesting Agency
Agency Location Code (ALC)
Treasury Account Symbol (TAS)
Business Event Type Code (BETC)
CCR/DUNS
Obligating Document Number (Attach Doc)
Additional information required for payment by
Government Purchase Card (GPC):
GPC number
GPC verification code
GPC Expiration Date (MM/YY)
GPC billing Zip Code
GPC Cardholder Name
Authorized Contact Information:
P.O.C. Name & Phone Number
P.O.C. Email Address
Financial/Certifying Official's Name
Financial/Certifying Official's Title
Sign/Date
Page 2 of 3
For OPM USE ONLY
T
o
Be Completed By Servicing Agency
24000001
24X4571.24
COLL
126536929
Karen English 202-606-2747
Karen.English@opm.gov
Daniel K. Marella
Deputy Chief Financial Officer
Sign/Date
0
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Page 3 of 3
PRESIDENTIAL RANK AWARD (PRA) EXPRESS BILLING
LIST OF NOMINEES
Requesting Agency
Agency Location Code (ALC)
Treasury Account Symbol (TAS)
Obligating Document Number (Attach Document)
NOMINEE NAMES
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Expressing Billing Form (U.S. Office of Personnel Management)

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Completed 18 July 2020

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