What You Need Before You Begin
Have the following details on hand before opening the form: the contract number, the identity codes for both the administration and purchasing offices, the contractor's name and CAGE code, the mailing address of the contractor, and any voucher or invoice numbers for final payment. If excess funds are being deobligated, note the amount in advance.
Click the "Get Form" button at the top of this page to open the online PDF editor.
Step 1: Complete the Administration Office Fields
Enter the contract number and the identity code for the contract administration office. Fill in the contractor's full name, identity code, and mailing address. In the final payment section, enter the voucher number and the date payment was issued. If a final approved invoice was submitted separately, add the invoice number and the date it was forwarded. Mark whether excess funds are being reported and enter the amount if applicable.
Step 2: Complete the Purchasing Office Fields
Enter the purchasing office identity code. Use the remarks field to note any price revisions, outstanding settlements, or special circumstances. Enter the typed name and signature of the responsible purchasing office official. Include the date of signature. Cross-check that the dates in both sections are consistent with contract records.
Pay close attention to the signature and typed name fields. Mismatched names or unsigned fields are the most common reasons this form is returned for correction.
Step 3: Review and Download
After entering all required information, click "Done" to finalize your form. Create a free FormsPal account to download the completed form as a PDF or send it by email right away. All data you enter is protected and is not stored or shared beyond your session.
Related Government Contract Forms
When closing out a contract, you may also need these related documents:
- Subcontractor Agreement - for documenting work performed by subcontractors
- Independent Contractor Agreement - for recording contractor engagement terms
- DD Form 1351-2 - Travel Voucher or Subvoucher used in government reimbursement
- FAR Contract Form - Federal Acquisition Regulation contract template
