Indian Affairs
Obligation in Expired Fund Request Form
(last revised: 9/11/2017)
This form is intended for use when requesting FBMS override privileges to record an obligation in an expired fund.
The policy governing this forms use can be found at: https://www.bia.gov/policy-forms/manual
Completed forms must be submitted via email to the Division of Financial Reporting and Analysis (FRA). Please
send to teri.lin@bia.gov and joshuar.williams@bia.gov
Section I. Requester Information
a. Last Name: b. First Name:
c. Phone #: d. Email:
e. Requesting Region/Program:
Section II. Obligation Information
a. Vendor Name:
b. FBMS Vendor Code:
c. Amount Requested for Obligation: d. Existing FBMS Document Number(s):
e. Date Good or Service was Ordered: f. Date Good or Service was Received:
Section III. Account Assignment Information
a. Fund: b. Funds Center:
c. Functional Area: d. Commitment Item:
e. WBS: f. Amount Available for Obligation:
Date Form Completed:
f. FBMS User ID of Staff Member Entering Purchase Request or Obligation into FBMS:
Section IV. Reason For Request
Section V. Please provide a brief description why the obligation was not recorded prior to fund expiration.
