Zero Dollar Payment Authorization Form

North Carolina Accounting System

Zero Dollar Payment Authorization Form

Date:___________________________

To: OSC NCAS Help Desk
        Financial Systems Division
        Office of the State Controller
        Phone #: (919) 875-HELP (4357)
        Fax #:      (919) 981-5561

From:
Name: _______________________________________

Title: _______________________________________

Agency: _______________________________________

Phone #: _______________________________________

_____________________________________ authorizes the OSC Help Desk to temporarily change the Zero Dollar
Agency Name
Payment Option on screen BAC for BAP code _____________________. We understand that this policy will allow all

zero dollars checks within this BAP code to be paid for one day.

_______________________________________________ ________________________________
Signature Date

This change authorization form was received by:

Help Desk Staff Member: ____________________________________ Date: ____________________________

Time agency was called: ____________________________________

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