SF1184

Unavailable Check Cancellation

Agency
GSA
Revision
Rev. 10/2005
Fillable fields
103
Pages
4
Official source
GSA form page
Checked
October 20, 2026
Fill SF1184 online
Page 1 of form SF1184

Standard Form 1184 (SF 1184): Unavailable Check Cancellation

Standard Form 1184 (SF 1184), Unavailable Check Cancellation, is a U.S. Department of the Treasury form. The header says it is prescribed by Dept. of the Treasury, cites I TFRM 4-7000 and names BGFO, the Bureau of Government Financial Operations. GSA hosts a copy in its forms library.

The form identifies a check by symbol, serial number, amount and date, with the agency or payee ID number, codes, the payee's name and address, and boxes for a decedent's name, date of death and an amount to be reclaimed. A For D.O. Use box lets the disbursing office record what it did with the request.

The PDF has four copies of the same page. The original says the administrative agency will forward it to BGFO through the disbursing office. You can fill it out free in your browser on this page and download the result without an account.

Top of page 1 of Standard Form 1184 (SF 1184): Unavailable Check Cancellation, as printed by GSA

What's on SF 1184

Check details

CK. SYM., Check Serial, Check Amount, CK. Date and AGY./Payee ID No.

Codes

Line Code, Stop CD. and Agency Code, with some parts of these boxes shaded on the form.

Payee name and address

Lines for the payee name and a three-line address.

Decedent and reclaim details

Name of Decedent, D. of Death, Amt. to be Reclaimed, AGY. Loc. Code and Agency Output, followed by an Agency Reference line.

For Agency Use

An open area for the agency with lines for the agency and a signature at the bottom.

For D.O. Use

Checkboxes for Request Processed, Payment returned and cancelled by DO on a date, No payment issued and Incorrect/incomplete SF 1184, then D.O. Activity and a signature.

Every copy prints the same boxes.

How to complete SF 1184

  1. 1

    Enter the check

    Fill in the check symbol, check serial, check amount, check date and the agency or payee ID number.

  2. 2

    Add the payee and any decedent details

    Enter the payee name and address. Where they apply, complete the name of decedent, date of death and amount to be reclaimed.

  3. 3

    Agency reference and signature

    Enter the agency reference, then the agency name and signature at the bottom of the For Agency Use area.

  4. 4

    Route the copies

    The original goes to BGFO through the disbursing office, and the administrative agency copy says the agency retains it for internal use.

  5. 5

    Disbursing office action

    The disbursing office marks the result in the For D.O. Use box and signs. Its copy says to retain it for internal use and send the agency receipt copy to the agency.

Why fill Form SF1184 on indox

You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.

  • Fill the form right in your browser, no software to install
  • Free to fill and free to download, with no account
  • The official blank straight from the GSA, not a copy someone retyped
  • Works on a phone, tablet or computer

Where it goes and what the form says

Where it goes

The original says ADMINISTRATIVE AGENCY WILL FORWARD TO BGFO THROUGH DISBURSING OFFICE. The PDF prints no address.

Four copies

Original for BGFO, a disbursing office copy the D.O. retains, an agency receipt copy the D.O. sends to the agency, and an administrative agency copy the agency retains.

Reproduction and edition

The form says AUTHORIZED FOR LOCAL REPRODUCTION and Previous Edition Unusable, and cites I TFRM 4-7000.

GSA's page

GSA's page lists form number SF1184 with a current revision date of 10/2005 and no authority or regulation.

Related forms

Who uses SF 1184?

  • The administrative agency

    The For Agency Use area ends with lines for the agency and a signature. The original copy says the administrative agency will forward it to BGFO through the disbursing office.

  • The disbursing office

    The For D.O. Use box has checkboxes for the result, a D.O. Activity line and a signature. The disbursing office keeps one copy and sends another to the agency.

  • BGFO

    The original copy goes to BGFO, the Bureau of Government Financial Operations named in the header, through the disbursing office.

  • Checks involving a decedent

    The form has boxes for the name of the decedent, the date of death and the amount to be reclaimed, for requests where those apply.

The form's signature lines and copy labels name an administrative agency, a disbursing office and BGFO. It has no section for a payee to sign.

Official sources and the blank

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Questions about Form SF1184

Who issues SF 1184?

The form says it is prescribed by Dept. of the Treasury, cites I TFRM 4-7000 and names BGFO, the Bureau of Government Financial Operations, in its header. GSA hosts a copy in its forms library.

Who fills out SF 1184?

The form has signature lines for an agency in the For Agency Use area and for the disbursing office in the For D.O. Use box. It has no section for a payee to sign.

Why does the PDF have four pages?

Each page is a copy: the original for BGFO, a disbursing office copy, an agency receipt copy and an administrative agency copy, each with its own routing note.

What can the disbursing office mark on SF 1184?

Request Processed, Payment returned and cancelled by DO on a date, No payment issued, or Incorrect/incomplete SF 1184.

Where does the original go?

The original says the administrative agency will forward it to BGFO through the disbursing office. The PDF prints no address.