Form AR-900A "Request to Remove Uncollectable Accounts Receivable From Agency Records" - New Jersey

What Is Form AR-900A?

This is a legal form that was released by the New Jersey Department of the Treasury - a government authority operating within New Jersey. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2002;
  • The latest edition provided by the New Jersey Department of the Treasury;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form AR-900A by clicking the link below or browse more documents and templates provided by the New Jersey Department of the Treasury.

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Download Form AR-900A "Request to Remove Uncollectable Accounts Receivable From Agency Records" - New Jersey

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Instructions
REQUEST TO REMOVE UNCOLLECTABLE
ACCOUNTS RECEIVABLE FROM AGENCY RECORDS
Department of the Treasury
IMPORTANT: IT IS IMPERATIVE THAT EITHER A
Division of Administration
SOCIAL SECURITY OR FEDERAL ID NUMBER BE
Special Administrative Services
SUPPLIED FOR EACH ACCOUNT LISTED.
Requesting Agency
DEPARTMENT:
DIVISION:
Code:
A = Approved
Permission is requested to remove the following accounts receivable that are deemed uncollectable:
D = Disapproved
Agency Assigned
Social Security or
Reason Account is
Date of Debt
Debtor's Name
Unpaid Amount
Nature of Debt
A/D
Account Number
FEIN No.
Uncollectable
Division of Administration, Special Administrative Services Unit - Recommendation:
CERTIFICATION
FINAL DETERMINATION
I hereby certify that all generally accepted collection
I hereby direct that the action
efforts were made and documentation in support of these
indicated above be taken for each of
efforts is on file at the agency location.
the items listed.
Agency Approval Officer
Title
Date
Director, Office of Management & Budget
Date
AR-900A (REV 11/2002)
Instructions
REQUEST TO REMOVE UNCOLLECTABLE
ACCOUNTS RECEIVABLE FROM AGENCY RECORDS
Department of the Treasury
IMPORTANT: IT IS IMPERATIVE THAT EITHER A
Division of Administration
SOCIAL SECURITY OR FEDERAL ID NUMBER BE
Special Administrative Services
SUPPLIED FOR EACH ACCOUNT LISTED.
Requesting Agency
DEPARTMENT:
DIVISION:
Code:
A = Approved
Permission is requested to remove the following accounts receivable that are deemed uncollectable:
D = Disapproved
Agency Assigned
Social Security or
Reason Account is
Date of Debt
Debtor's Name
Unpaid Amount
Nature of Debt
A/D
Account Number
FEIN No.
Uncollectable
Division of Administration, Special Administrative Services Unit - Recommendation:
CERTIFICATION
FINAL DETERMINATION
I hereby certify that all generally accepted collection
I hereby direct that the action
efforts were made and documentation in support of these
indicated above be taken for each of
efforts is on file at the agency location.
the items listed.
Agency Approval Officer
Title
Date
Director, Office of Management & Budget
Date
AR-900A (REV 11/2002)