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Electronic Forms


Many Departmental forms are now available online to better serve USDA employees and customers. The majority of these forms are used for administrative purposes. Most of the forms on this list will need to be downloaded in order to function fully. If you encounter a problem when attempting to open a form, we advise you to copy the form link and paste it into a different browser.

USDA is actively working to make all of its publicly available forms Section 508 accessible. If you need a form that is not Section 508 accessible, please contact the form owner listed or OBPA DPO and we will make every effort to obtain an accessible copy for you.

Prefix

Form No.

Subject

PDF

AD

59

Request for Manuscript Review

FILL IN PDF (PDF, 57.5 KB)

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78

Request for Printing and Binding

FILL IN PDF (PDF, 741 KB)

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107

Report of Transfer or other Disposition or Construction of Property

FILL IN PDF (PDF, 100 KB)

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110

Detailed Cost Analysis

PDF (PDF, 181 KB)

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112

Report of Unserviceable, Lost or Damaged Property

FILL IN PDF (PDF, 162 KB)

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116

Clearance & Approval for Departmental Issuances

FILL IN PDF (PDF, 694 KB)

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121

Passport Request

PDF (PDF, 43.8 KB)

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139

Final Salary Payment Report

PDF (PDF, 209 KB)

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156

External Distribution

PDF (PDF, 32.9 KB)

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159

Interagency Publication Clearance Form

PDF (PDF, 143 KB)

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156A

External Distribution - Room 0466 - South Building

FILL IN PDF (PDF, 183 KB)

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202

Travel Authorization/Advance

FILL IN PDF (PDF, 224 KB)

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202M

Travel Authorization/Advance for multiple travelers

FILL IN PDF (PDF, 53.1 KB)

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0202R

Travel Authorization/Advance Attachment for Relocation Travel

FILL IN PDF (PDF, 333 KB)

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202RE

Travel Authorization/Advance Separate Relocation Allowances

FILL IN PDF (PDF, 180 KB)

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216

Voucher Difference Statement

PDF (PDF, 41.6 KB)

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234

Charge Out Card

PDF (PDF, 164 KB)

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270

Request for Copy/Duplicating Service

FILL IN PDF (PDF, 626 KB)

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271

Request for Photographic Services

FILL IN PDF (PDF, 1.0 MB)

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287

Employee Suggestion

PDF (PDF, 202 KB)

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287-2

Recommendation and Authorization of Monetary and Time Off Awards

FILL IN PDF (PDF, 761 KB)

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311

Speed Memo

PDF (PDF, 34.2 KB)

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332

Position Description Cover Sheet

PDF (PDF, 4.1 MB)

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334

Statement of Earnings and Leave

PDF (PDF, 42.1 KB)

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343

Payroll Action Request

FILL IN PDF (PDF, 107 KB)

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349

Employee Address

FILL IN PDF (PDF, 70.6 KB)

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354

Request for Information

FILL IN PDF (PDF, 271 KB)

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382

Employee Claim for Loss or Damage to Personal Property

FILL IN PDF (PDF, 160 KB)

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424

Reimbursement of Expenses Upon Sale or Purchase of Residence Upon Change of Station

PDF (PDF, 74.5 KB)

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435C

Senior Executive Service Appraisal Record

PDF (PDF, 135 KB)

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435E

Performance Plan and Appraisal for Non-Supervisors

FILL IN PDF (PDF, 52.2 KB)

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435S

Performance Plan and Appraisal for Supervisors

FILL IN PDF (PDF, 55.3 KB)

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471

Classified Document Accountability Record

PDF (PDF, 94.8 KB)

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474

Transmittal - Telephone and Utilities

FILL IN PDF (PDF, 198 KB)

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475A

And Justice For All Poster (Assisted Programs)

PDF

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475B

And Justice For All Poster (SNAP and FDPIR Programs)

PDF

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475C

And Justice For All Poster (Conducted Programs)

PDF

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475D

And Justice for All Poster (Title IX Programs)

PDF

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495

Secretary’s Honor Awards Nomination Form

FILL IN PDF (PDF, 1.1 MB)

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507a

Probationary or Trial Period Report

PDF (PDF, 84.6 KB)

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567

Teleticket Payment Transmittal

PDF (PDF, 57.1 KB)

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568

Transmittal-Credit Card-Gasoline

PDF (PDF, 55.1 KB)

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581

Lump-Sum Leave or Compensatory Time Payments

FILL IN PDF (PDF, 464 KB)

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582

Authorization for Restored Annual Leave

PDF (PDF, 196 KB)

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616

Travel Voucher (Temporary Duty Station)

FILL IN PDF (PDF, 799 KB)

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616N

Travel Voucher (Temporary Duty Travel)

FILL IN PDF (PDF, 694 KB)

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616R

Travel Voucher (Relocation)

FILL IN PDF (PDF, 387 KB)

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617

Schedule of Expenses

FILL IN PDF (PDF, 253 KB)

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633

Multi-use Standard Requisitioning

PDF (PDF, 49.5 KB)

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652

Request for Creative Services

PDF (PDF, 323 KB)

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658

Within-Grade Increase Record

PDF (PDF, 75.6 KB)

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672

Reimbursement or Advance of Funds Agreement

FILL IN PDF (PDF, 391 KB)

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673

Request to Bill

PDF (PDF, 52.5 KB)

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687

Forms Action Request and Notice

PDF (PDF, 282 KB)

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690

Transmittal Record

PDF (PDF, 37.9 KB)

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700

Purchase Request

FILL IN PDF (PDF, 44.3 KB)

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718

Period End -Estimates

PDF (PDF, 106 KB)

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728

Request and Authorization for Home to Work Transportation

PDF (PDF, 72.2 KB)

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734

Request for Candidates

PDF (PDF, 86.3 KB)

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735

Evaluation of Candidates

PDF (PDF, 129 KB)

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742

Disbursements (Expense)

FILL IN PDF (PDF, 233 KB)

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755

Advisory Committee or Research and Promotion Background Information

FILL IN PDF (PDF, 2.9 MB)

AD

755 Supplemental List

AD-755 Supplemental List
AMS Commodity Specific Questions

FILL IN PDF (PDF, 308 KB)

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757

Miscellaneous Payment System

PDF (PDF, 86.4 KB)

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778

Secretary's Memorandum Template

PDF (PDF, 104 KB)

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779

Employee Biographical Sketch

PDF (PDF, 144 KB)

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811

Departmental Regulation Template

PDF (PDF, 214 KB)

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812

Departmental Manual Template

PDF (PDF, 229 KB)

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813

Departmental Notice Template

PDF (PDF, 248 KB)

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814

Departmental Guidebook Template

PDF (PDF, 120 KB)

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834

IRM Technical Approval Request Certification

PDF (PDF, 116 KB)

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835

IRM System and Service Security Certification

PDF (PDF, 72.4 KB)

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838-7

Purchase Order

PDF (PDF, 105 KB)

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838-B

Invoice - Receipt Notification

PDF (PDF, 136 KB)

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838-D

BPA - Invoice - Receipt Certification

PDF (PDF, 123 KB)

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838-I

Invoice Cover Sheet for IAS Payments (IAS-001)

PDF (PDF, 146 KB)

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873

Property Pass

PDF (PDF, 122 KB)

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881

Individual Development Plan

FILL IN PDF (PDF, 103 KB)

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894

Request for Cropland Waiver

PDF (PDF, 83.2 KB)

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955

GSA Telephone Transmittal

FILL IN PDF (PDF, 472 KB)

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956

Request for Originating Office Number Action

PDF (PDF, 355 KB)

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1000

Certified Statement of Income and Tax Filing Status Relocation Income Tax Allowance (RITA)

FILL IN PDF (PDF, 1.5 MB)

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1026A

Farming Interest

USDA Service Center eForms
PDF

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1026B

Highly Erosive Land Conservation Exemption Request

USDA Service Center eForms
PDF

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1026C

Landlord or Landowner Exemption Request

USDA Service Center eForms
PDF

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1026D

Relief for Undue Economic Hardship Request Highly Erosive Land Conservation

USDA Service Center eForms
PDF

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1026

Highly Erosive Land Conservation (HELC) and Wetland Conservation (WC) Certification

USDA Service Center eForms
PDF

AD

1026

Certification de Conservation de Tierras Altamente Erosionables ("HELC") Y de Plantanos ("WC")

USDA Service Center eForms
PDF

AD

1043

Leave Transfer Program-Donor Application

FILL IN PDF (PDF, 132 KB)

AD

1046

Leave Transfer Program - Recipient Application

FILL IN PDF (PDF, 125 KB)

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1047

Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions

PDF (PDF, 310 KB)

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1048

Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions

PDF (PDF, 304 KB)

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1049

Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative I – For Grantees Other Than Individuals

PDF (PDF, 318 KB)

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1050

Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative II – For Grantees Who Are Individuals

PDF (PDF, 310 KB)

AD

1052

Certification Regarding Drug-Free Workplace State and State Agencies, Federal Fiscal Year

PDF (PDF, 303 KB)

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1068

Good Faith Determination- Highly Erosive Land Activity

PDF (PDF, 154 KB)

AD

1068A

Distribution of Graduated Payment Reduction

PDF (PDF, 80.6 KB)

AD

1069

Good Faith Determination- Wetland Activity

PDF (PDF, 89.7 KB)

AD

1073

Recommendation and Approval of- Recruitment/ Relocation Bonus or Retention Allowance

PDF (PDF, 103 KB)

AD

1074

Service Agreement for Receipt of Payment for a Recruitment/ Relocation Bonus

PDF (PDF, 73.0 KB)

AD

1083 INS

Instructions for Completing Form AD-1083

PDF (PDF, 58.1 KB)

AD

1083

Request for Action for Procedures/Reports

PDF (PDF, 102 KB)

AD

1083A

Continuation Sheet for Ordering Procedures

PDF (PDF, 130 KB)

AD

1086

Applicant Supplemental Sheet

PDF (PDF, 148 KB)

AD

1095

Accounting/Pay Period Calendar

PDF (PDF, 301 KB)

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1095A

Accounting/Pay Period Calendar

PDF (PDF, 305 KB)

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1098

Sick Leave Hours Used for Family Members

PDF (PDF, 281 KB)

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1101

Acceptance of Payment for Travel Expenses from a Non-Federal Source

PDF (PDF, 292 KB)

AD

1102

Special Processing Transmittal

PDF (PDF, 1.3 MB)

AD

1128

Identification Request for Electronic Downloading of Software from NFC

FILL IN PDF (PDF, 189 KB)

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1130

Doing Business With USDA Kit

USDA Procurement Web Site

AD

1138

Option B and C Election Notice for Retirement

FILL IN PDF (PDF, 87.5 KB)

AD

1143

Corporate Systems Access Request Form

FILL IN PDF (PDF, 254 KB)

AD

1151

Recommendation and Approval of the Repayment of Student Loans(s)

PDF (PDF, 131 KB)

AD

1152

Service Agreement for a Receipt of Repayment of Student Loan(s)

PDF (PDF, 153 KB)

AD

1153

Application for Long-Term Contracted Assistance Through the _____ Program

USDA Service Center eForms
PDF

AD

1154

NRCS Long-Term Agreement

USDA Service Center eForms
PDF

AD

1155

Conservation Plan Schedule of Operations

USDA Service Center eForms
PDF

AD

1155A

Conservation Plan Schedule of Operations

USDA Service Center eForms
PDF

AD

1156

Revision of Plan or Schedule of Operations or Modification of a Contract

USDA Service Center eForms
PDF

AD

1157

Option Agreement to Purchase

USDA Service Center eForms
PDF

AD

1157A

Option Agreement to Purchase
Amendment 1

USDA Service Center eForms
PDF

AD

1158

Subordination Agreement and Limited Lien Waiver

USDA Service Center eForms
PDF

AD

1159

Notice of Intent to Continue

USDA Service Center eForms
PDF

AD

1160

Compatible Use Authorization

PDF (PDF, 92.3 KB)

AD

1161

Application for Payment

PDF (PDF, 61.0 KB)

AD

1163

Confirmation of Request for Reasonable Accommodation

PDF (PDF, 73.5 KB)

AD

1164

Reasonable Accommodation Information Reporting Form

PDF (PDF, 87.7 KB)

AD

1165

Denial of Reasonable Accommodation Request

PDF (PDF, 104 KB)

AD

1168

Corporate System Change Request(CR) with Instructions

PDF (PDF, 144 KB)

AD

1170

Transit Subsidy Cash Reimbursement Certification

PDF (PDF, 58.4 KB)

AD

1173A

CD-ROM Request

PDF (PDF, 80.4 KB)

AD

1185

Pre-Tax Parking Application

PDF (PDF, 124 KB)

AD

1190

Farm/Business Assessment

PDF (PDF, 284 KB)

AD

1197

Request for USDA Site Badge

FILL IN PDF (PDF, 217 KB)

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1202

USDA Confidential Conflict of Interest Certification

PDF (PDF, 204 KB)

AD

1205

USDA Small Business Program - Procurement Request Review

PDF (PDF, 134 KB)

AD

1208

Senior Leadership Potential Assessment

PDF (PDF, 315 KB)

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AD

2000

Performance Plan Agreement and Appraisal

PDF (PDF, 202 KB)

AD

2001

Designation of Tour of Duty

PDF (PDF, 139 KB)

AD

2002

Time and Attendance Record

PDF (PDF, 146 KB)

AD

2003

Spouse Consent to Survivor Election

FILL IN PDF (PDF, 89.1 KB)

AD

2005

Executive Potential Program Nomination Form

FILL IN PDF (PDF, 68.2 KB)

AD

2008

Executive Leadership Program for Mid-Level Employees Nomination Form

FILL IN PDF (PDF, 98.7 KB)

AD

2010

Federal Executive Institute (FEI) Nomination Form

FILL IN PDF (PDF, 178 KB)

AD

2014

New Leader Program (NLP) Nomination Form

FILL IN PDF (PDF, 94.4 KB)

AD

2015

USDA Congressional Fellowship Program Nomination Form

FILL IN PDF (PDF, 134 KB)

AD

2017

Service Center Information Management System (SCIMS) Access Form

FILL IN PDF (PDF, 116 KB)

AD

2021

Aspiring Leader Program (ALP) Nomination Form

FILL IN PDF (PDF, 95.9 KB)

AD

2022

Student Volunteer Agreement

PDF (PDF, 277 KB)

AD

2047

Customer Data Worksheet

PDF (PDF, 335 KB)

AD

2047S

Customer Data Worksheet (Spanish version)

PDF (PDF, 315 KB)

AD

2059

Identification and Approval of Information Shipped Via Next Day or Express Service

PDF (PDF, 1.0 MB)

AD

2102

Request for Special Priorities Assistance for Emergency Preparedness Activities

FILL IN PDF (PDF, 384 KB)

AD

2106

Questionnaire to Assist in the Assessment of USDA Compliance with Civil Rights Laws

PDF (PDF, 105 KB)

AD

3001

Documentary Materials Removal/Non-removal Certification and Non-disclosure Agreement

PDF (PDF, 310 KB)

AD

3002

Separation Checklist for Non-Career Appointees
(rev 12-08)

PDF (PDF, 303 KB)

AD

3003

Software Change Request
(rev 09-15)

FILL IN PDF (PDF, 349 KB)

AD

3006

POST-1956 Military Service Deposit Checklist

FILL IN PDF (PDF, 404 KB)

AD

3010

Senior Executive Service Performance Plan and Appraisal Record

PDF (PDF, 483 KB)

AD

3018

Telework Agreement

FILL IN PDF (PDF, 878 KB)

AD

3020

Supervisor Onboard Checklist

PDF (PDF, 169 KB)

AD

3022

New Media Request Form

PDF (PDF, 209 KB)

AD

3025

USDA 1890 National Scholars Program Application for High School Students

PDF (PDF, 635 KB)

AD

3026

USDA 1890 National Scholars Program Application for College Students

PDF (PDF, 634 KB)

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3027

USDA Program Discrimination Complaint Form

 

 

3027 English (PDF, 293 KB)

3027 Arabic (PDF, 392 KB)

3027 Chinese Simplified (PDF, 398 KB)

3027 Chinese Traditional (PDF, 527 KB)

3027 French (PDF, 871 KB)

3027 German (PDF, 314 KB)

3027 Hebrew (PDF, 346 KB)

3027 Haitian Creole (PDF, 307 KB)

3027 Italian (PDF, 284 KB)

3027 Japanese (PDF, 1.1 MB)

3027 Korean (PDF, 516 KB)

3027 Polish (PDF, 302 KB)

3027 Portuguese (PDF, 729 KB)

3027 Punjabi (PDF, 725 KB)

3027 Russian (PDF, 888 KB)

3027 Spanish (PDF, 303 KB)

3027 Tagalog (PDF, 295 KB)

3027 Urdu (PDF, 383 KB)

3027 Vietnamese (PDF, 415 KB)

3027 Yiddish (PDF, 336 KB)

 

 

AD

3030

Representations Regarding Felony Conviction and Tax Delinquent Status for Corporate Applicants

PDF (PDF, 640 KB)

AD

3038

Cyber Security PII Incident Report Form

PDF (PDF, 788 KB)

AD

3040

Request for Exception to
DR 1430-002

PDF (PDF, 167 KB)

IAS

001

Invoice Cover Sheet for IAS Payments

FILL IN PDF (PDF, 344 KB)

AD

3041

Waiver/Cancellation Request

FILL IN PDF (PDF, 44.9 KB)

AD

3042

INSIGHT Access Request Form

PDF (PDF, 184 KB)

AD

3043

ASOC Incident Report

PDF (PDF, 279 KB)

AD

3050

PII NON DISCLOSURE AGREEMENT PII

PDF (PDF, 123 KB)

AD

3061

Container Examination Worksheet – Table IV- Metal Containers

FILL IN PDF (PDF, 705 KB)

AD

3062

Container Examination Worksheet – Table V- Composite Containers

FILL IN PDF (PDF, 200 KB)

AD

3063

Container Examination Worksheet – Table VI- Glass Containers

FILL IN PDF (PDF, 196 KB)

AD

3064

Container Examination Worksheet – Table VII- Plastic Containers

FILL IN PDF (PDF, 626 KB)

AD

3065

Container Examination Worksheet – Table IV- Rigid and Semi-Rigid Containers

FILL IN PDF (PDF, 660 KB)

AD

3066

Container Examination Worksheet – Table IV- Flexible Containers

FILL IN PDF (PDF, 1.3 MB)

AD

3070

Reemployment Priority List (RPL) Registration Sheet

PDF (PDF, 439 KB)

AD

3072

Recruit Action Supplement Form

PDF (PDF, 191 KB)

AD

3073

Senior Executive Service Probationary Period Certification

PDF (PDF, 262 KB)

AD

3074

Request for Recruitment Action

PDF (PDF, 189 KB)

AD

3075

Executive Resources Personnel Action Selection Request

PDF (PDF, 139 KB)

AD

3077

USDA Superior Qualifications and Special Needs Pay Setting Authority

PDF (PDF, 255 KB)

AD

3080

Classified Stand-Alone Computer User Agreement

FILL IN PDF (PDF, 171 KB)

AD

3081

Classified Stand-Alone Computer Registration / Certification

FILL IN PDF (PDF, 300 KB)

AD

3082

Classified Stand-Alone Computer User Account Termination

FILL IN PDF (PDF, 155 KB)

AD

3083

Justification Request for an HSDN Account

FILL IN PDF (PDF, 190 KB)

AD

3084

Justification for a Classified National Security Information System

FILL IN PDF (PDF, 184 KB)

AD

3085

Classified Stand-Alone Computer User Account Authorization

FILL IN PDF (PDF, 155 KB)

AD

3086

Classified Stand-Alone Computer System POC Change Request

PDF (PDF, 167 KB)

AD

3100-A

National Finance Center Agency Security Officer Designation Form

PDF (PDF, 184 KB)

AD

3100-DSA

National Finance Center Agency Distributed Security Administrator Designation Form

PDF (PDF, 129 KB)

AD

3100-P

National Finance Center Payroll Personnel Request for Security Access

PDF (PDF, 363 KB)

AD

3100-R

National Finance Center Reporting Center Request for Security Access Form

PDF (PDF, 264 KB)

AD

3100-T

National Finance Center Tribal Insurance Processing System (TIPS) Request for Security Access

PDF (PDF, 259 KB)

AD

3106

Software Validation Form

PDF (PDF, 311 KB)

AD

3107

Request for USDA CIO Council Action

PDF (PDF, 240 KB)

AD

3108

Note to Reviewers for
Draft USDA Departmental Directives

FILL IN PDF (PDF, 1.2 MB)

AD

3109

USDA Reorganization Work Plan

FILL IN PDF (PDF, 1.1 MB)

AD

3110

Purchase Card: Non-Required Source Vendor Form

FILL IN PDF (PDF, 278 KB)

AD

3111

Digital Signage Request Form

FILL IN PDF (PDF, 223 KB)

AD

3113

Secure File Transfer Protocol (SFTP) File Transmission Request

FILL IN PDF (PDF, 177 KB)

AD

3115

Recommendation and Authorization of Quality Step Increase (QSI)

FILL IN PDF (PDF, 136 KB)

AD

3121

USDA Employee Citizenship Form

PDF (PDF, 80.3 KB)

AD

3125

Eligibility Questionnaire for Havana Act Payments

PDF (PDF, 189 KB)

AD

3126

USDA Phone or Meeting Response to Correspondence Documentation Form

PDF (PDF, 152 KB)

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