For GPO Use Only
Deposit Account (Printing and Binding) Form 4045
Date received
Check Only One Action (Establish, Replenish, Refund, or Transfer)
New BAC
Date BAC and
Establish a New Deposit Account New Deposit Account Amount $
password sent
to customer
Replenish an Existing Deposit Account
Date DD Form 448-2
signed and sent
Refund Request on a Deposit Account
back to customer
Billing Address Code (BAC)
Billing Address Code (BAC) Replenish Amount $
Refund Amount $
Transfer Request From BAC To BAC Amount of Transfer $
MIPR — (Military Interdepartmental Purchase Request) and acceptance of MIPR attached.
(Required for IPAC Funding)
Agency Location Code (ALC) Business Event Type Code (BETC)
Treasury Account Symbol (TAS)
Sub-level Allocation Transfer
Agency
Prefix Code (2) Agency Identifier (3)
Identifier (3)
Beginning Period
of Availability (4)
Ending Period of
Availability (4)
Availability Type
Code (1)
Main Account
Code (4)
Sub-Account
Code (3)
Update: Change administrator Add a backup administrator
AGENCY DEPOSIT ACCOUNT ADMINISTRATOR
Contact information (Administrator or Finance POC)
Name
Department or Government Establishment
Address
Phone Ext. Fax
Bureau/Office
Email
AGENCY FINANCE POINT-OF-CONTACT INFORMATION
Name
Address
Phone Ext. Fax Email
LOA or MIPR Information
(Go to https://www.gpo.gov/docs/default-source/finance-options-pdf-files/sf1-loa.pdf for more information.)
Additional Information
I certify that the advanced transfer of funds is authorized by law and necessary to the conduct of official Government business of the above-mentioned
establishment. I understand that this form authorizes the transfer of funds for the Deposit Account Program and that my Government establishment is
responsible for ensuring that the funds are available for the fiscal year in which they are obligated with a Standard Form 1.
Authorizing Signature (must be on file with GPO) Title Date
IPAC Submit completed form to the Accounts Receivable
FUNDING & Collections Office at arc@gpo.gov
For further information regarding Deposit Accounts go to
https://www.gpo.gov/docs/default-source/forms-standards-pdf-files/
depositacct_form4045_inst.pdf or call 202.512.1189.
CHECK Mail completed form with check, made payable to the:
FUNDING U.S. Government Publishing Office
732 North Capitol Street, NW
Room B-622, Disbursing Office
Washington, DC 20401
Please indicate “Deposit Account” and your BAC on check.
GPO Form 4045 R. 03/2015
click to sign
signature
click to edit
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