Forms for State and Local Government Series Securities, Tax and Loss Bonds, and FHA Debentures

Two Convenient Ways to Get a Form...

BY DOWNLOADING:


Some of our most requested forms are available for download in Portable Document Format (PDF). To read or print a PDF document, you need the Adobe Acrobat Reader software installed on your PC. Adobe Systems, Inc. permits the Bureau of the Public Debt and other organizations to offer this software to the public free of charge. You can download the Adobe Acrobat Reader from the Adobe web site.

BY MAIL:

By Mail

We can mail any of the listed forms to you and you should receive them in about a week. Make your selection(s) in the far right column of the table below, then scroll to the bottom of the page to enter your mailing address.

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Note: If you need more than one copy of a form read here.


Select a Category or Scroll Through the List of Forms

To select the form you need, select the appropriate category from the list below. After you select a category, you'll see a more detailed description of each form. If you prefer, you can scroll through the entire list of available forms--you'll find a complete listing just below the Forms Categories.

You should mail your completed forms to: Division of Special Investments, P.O. Box 396, Parkersburg, WV 26106-0396. The address to use for courier services or certified mail is: Division of Special Investments, 200 Third Street, Parkersburg, WV 26106-0396.

Form Categories


List of Available Forms


FHA Debentures
By DownloadingForm NumberForm DescriptionBy Mail
PDF
file size-479K
file uploaded
03/17/2003
Fillable Form
PD F 5354
FHA TRANSACTION REQUEST
Make changes to an FHA Debenture account.
PDF
file size-65K
file uploaded
04/10/2003
Fillable Form
PD F 5366
FHA NEW ACCOUNT REQUEST
Request a new FHA Debenture
PDF
file size-456K
file uploaded
03/17/2003
Fillable Form
PD F 5367
FHA DEBENTURE TRANSFER REQUEST
Request an FHA Debenture transfer.
State and Local Government Series (SLGS) Securities
By DownloadingForm NumberForm DescriptionBy Mail
PDF
file size-60K
file uploaded
08/15/2005
Fillable Form
PD F 4144
SUBSCRIPTION FOR PURCHASE AND ISSUE OF U.S. TREASURY SECURITIES
State and Local Government Series/Time Deposit
PDF
file size-85K
file uploaded
08/15/2005
Fillable Form
PD F 4144-1
ACCOUNT INFORMATION FOR U.S. TREASURY SECURITIES
State and Local Government Series/Time Deposit
PDF
file size-93K
file uploaded
08/15/2005
Fillable Form
PD F 4144-2
SCHEDULE OF U.S. TREASURY
State and Local Government Series/ Time Deposit
PDF
file size-326K
file uploaded
08/15/2005
Fillable Form
PD F 4144-5
SLGSafeSM APPLICATION FOR INTERNET ACCESS
U.S Treasury State and Local Government Series
PDF
file size-41K
file uploaded
08/15/2005
Fillable Form
PD F 4144-6
SLGSafe USER ACKNOWLEDGMENT, SLGSafe APPLICATION FOR INTERNET ACCESS
Attach this to your SLGSafeSM application.
PDF
file size-79K
file uploaded
08/15/2005
Fillable Form
PD F 4144-7
SLGSafeSM TEMPLATE WORKSHEET
PDF
file size-177K
file uploaded
08/15/2005
Fillable Form
PD F 5237
SUBSCRIPTION FOR PURCHASES OF U.S. TREASURY SECURITIES - SLGS ONE-DAY CERTIFICATE OF INDEBTEDNESS
Buying a SLGS one-day Certificate of Indebtedness/Demand Deposit.
PDF
file size-212K
file uploaded
08/15/2005
Fillable Form
PD F 5238
REQUEST FOR REDEMPTION OF US TREASURY SECURITIES - SLGS ONE-DAY CERTIFICATE OF INDEBTEDNESS
Redeeming a SLGS one-day Certificate of Indebtedness/Demand Deposit.
PDF
file size-332K
file uploaded
08/15/2005
Fillable Form
PD F 5377
US TREASURY SECURITIES SLGS EARLY REDEMPTION REQUEST
Tax and Loss Bonds
By DownloadingForm NumberForm DescriptionBy Mail
PDF
file size-66K
file uploaded
03/18/2003
Fillable Form
PD F 3871
APPLICATION FOR ISSUE OF UNITED STATES MORTGAGE GUARANTY INSURANCE COMPANY TAX AND LOSS BONDS
Application for purchasing a Tax and Loss Bond.

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