AC3377 AGENCY FUND REQUEST

AC 3377 (Rev. 8/31/26)

Agency name:

Business unit:

Fund title: Character limit (min. 1 - max. 30)

General purpose of this new fund:

Bank account:

Revenue source:

Please describe.

If applicable, please provide the statute which created this fund and designates a revenue source:

Chapter:

Section:

Laws of:

Page number:

Line number:

If a statute is not applicable, this fund must be added to the Revenue Deposit List by Division of the Budget before submitting this form.

Disbursements:

Please describe the type of payments which will be made.

Is this fund subject to appropriation:

§4 of the State Finance Law provides: Notwithstanding the provisions of any other section of law to the contrary, no money shall be paid from any fund under the management of the state, or any agency or officer thereof except in pursuance of an appropriation by law. (Note: An exception to the above is provided for funds held in a trust capacity (e.g. funds held in escrow by the state as agent for a 3rd party)).

If Yes, please provide statutory reference where the appropriation may be found:

Chapter:

Section:

Laws of:

Page number:

Line number:

Should this fund receive interest earnings on its Average Daily Balance?

Does this fund have temp loan authority?

Signature:

Phone number:

Format: (000) 000-0000.

Email:

Title:

Date:

MonthDayYear

Your request will be submitted to the OSC Bureau of State Accounting Operations. A confirmation email will be received at the email address provided in this form. If you have any questions, please contact BSAOChartOfAccounts@osc.ny.gov.