Follow the steps to accurately complete the form.

1. Click the ‘Get Form’ button to access the form and open it in your chosen application.
2. In Section I, select your position by marking the appropriate box for either Agency Program Coordinator, Convenience Check Account Holder, Alternate APC, or Approving Official. Fill in your last name, first name, middle initial, and complete your office mailing address with city, state, and ZIP code.
3. Provide your telephone numbers, including area codes for both commercial and DSN lines. Additionally, fill in the fax numbers if applicable.
4. Enter your email address clearly and provide the full name of your agency, spelling it out completely (for example, Corps of Engineers).
5. Indicate the military service you support, such as Army or Navy, and specify your location (for example, Ft Knox).
6. For the mandatory APC name, input the full name of the individual authorized to manage the program at your location.
7. In Section II, if you are a Convenience Check Account Holder, enter the account number exactly as it appears at the bottom of your check. Do not use your bank statement account number.
8. In Section III, list the names and account numbers of each convenience check account holder for whom you are responsible. Ensure this information does not include your own bank account number. If further space is needed, attach a separate sheet.
9. Once you have completed all necessary sections, review your entries for accuracy. You can then save any changes made to the form, download it for your records, print a physical copy, or share it as required.

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