FEDLINK IAG ACCOUNT ADJUSTMENT AMENDMENT
TERMINATE SERVICES/FUNDS or REFUND

Use this form to terminate a service and/or request a refund from a Transfer Pay Account.
 (Step-by-Step Instructions)

Enter the fiscal year in the box below and then complete the remaining sections.
Fiscal Year (One form per fiscal year)

B: TERMINATE SERVICE for Transfer Pay Account (Be sure the account balance is zero.)
Service ID and Name
Transfer
Transfer
I authorize FEDLINK to terminate the services provided under my IAG from the vendor specified above.
I certify that, as of the date of this request, my agency will no longer place orders with or use the service of the above vendor under the LC/FEDLINK BOA. Any additional charges accured will be responsibility of my agency.
I will complete Section C to instruct FEDLINK on how to handle any funds remaining in the terminated service account.
C: REFUND FUNDS for Transfer Pay Account
Account Service ID and Name Action Service Dollars Amount
(No Commas)
Transfer Refund $
Transfer Refund $
Transfer Refund $
Transfer Refund $
Transfer Refund $
Transfer Refund $
Transfer Refund $
Transfer Refund $
Total Decrease $