Note: Many of these forms are in PDF format and require the use of Adobe Acrobat Reader.


Accounting Forms

Affidavit for Lost Receipts - example

State of Nebraska Substitute Form W-9 &
ACH Enrollment Form
    April version  7-3-14

Replaces  Nebraska ACH Enrollment Form and the W-9 Nebraska Substitute

Petty Cash Fund Application  (updated 4-07) and Instruction

Fund Request  and Instruction

Investment Authorization

Grant Updates – Email attachment form

Nebraska W-9 – Completed by State of Nebraska

Nebraska Resale or Exempt Sale Certificate Form 13 Completed by State of Nebraska

Nebraska & Local Sales and Use Tax  Authorizaton – Form 10 - use the Department  of Revenue Link in General Policies 36 for Agency use only.

Request for Stop Pay/Replacement Warrant (Excel)  Updated 5-5-14
and Instruction  Updated 5-6-15

Request for Travel by Personally Rented or Privately Owned Airplane

Request to Approve or Renew a Volunteer Program

Purchasing Card Account Information Form and Instructions

Example of Travel Request Form PDF
 Travel Request Guide (screen reader accessible)

Warrant Cancellation Form (Excel)  Warrant Cancellation Certification


Expense Reimbursement Document 2014 (Excel)




Statewide Business Unit Access Confidentiality Agreement

Employee Transfer Between Agencies

Payroll Forms

Authorized Agent Request Form – Employee Transfer Between Agencies – Payroll & Financial

Bus Pass

Commuting - Monthly Employee Report “ Example”(Word)   

Direct Deposit Enrollment Form Updated 8-1-13

Employee Payment Transmittal Form

Employer Report of Special Wage Payments

Interim Direct Payment Worksheet

Interim Payroll Worksheet

Payroll Calculation Spreadsheet for 2015a (Excel)  Updated 5/5/15

Instruction for paycal


Payroll Card Information Form  Updated 11-6-12
and Payroll Card Instruction

Payroll Certification Form   and Instruction


Request for Payroll Emergency Stop Pay/Replacement  Warrant (Excel)  Updated 5-6-14 and Instruction  updated 5-6-14

Retirement Estimator –Link to Social Security Web site

Service Date Adjustment Form  New 5-17-13

W-4 Calculation      Instruction for W-4 Calculation   5-13-14

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