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SLGS Forms

Click on the links below to access the State and Local Government Series (SLGS) Securities forms. This includes those forms necessary for sign up with SLGSafe and the original forms for purchase of SLGS.

SLGS forms should be completed and e-mailed to SIB at SLGS@fiscal.treasury.gov.

NOTE: Hard copies of SLGS forms (intent to purchase and redemption) should only be used in situations where SIB tells you to do so. In all other circumstances, SLGSafe should be used to conduct your SLGS business.

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

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.

The forms below are Adobe PDF documents.  You can fill them out on your computer.

Form Categories

List of Forms
FHA Debentures
Form Number Title, Description, Size
FS 5354 FHA TRANSACTION REQUEST
Make changes to an FHA Debenture account.
Size: 224 K Uploaded 08/17/2018
FS 5366 FHA NEW ACCOUNT REQUEST
Request a new FHA Debenture
Size: 187 K Uploaded 08/17/2018
FS 5367 FHA DEBENTURE TRANSFER REQUEST
Request an FHA Debenture transfer.
Size: 225 K Uploaded 08/17/2018
State and Local Government Series (SLGS) Securities
Form Number Title, Description, Size
FS 4144 SUBSCRIPTION FOR PURCHASE AND ISSUE OF
U.S. TREASURY SECURITIES
State and Local Government Series/Time Deposit
Size: 204 K Uploaded 08/17/2018
FS 4144-1 ACCOUNT INFORMATION FOR U.S. TREASURY SECURITIES
State and Local Government Series/Time Deposit
Size: 279 K Uploaded 08/17/2018
FS 4144-2 SCHEDULE OF U.S. TREASURY
State and Local Government Series/ Time Deposit
Size: 347 K Uploaded 08/17/2018
FS 4144-5 SLGSafeSM APPLICATION FOR INTERNET ACCESS
U.S. Treasury State and Local Government Series
Size: 354 K Uploaded 01/08/2024
FS 4144-6 SLGSafeSM USER ACKNOWLEDGMENT, SLGSafe
APPLICATION FOR INTERNET ACCESS
Attach this to your SLGSafeSM application.
Size: 203 K Uploaded 01/08/2024
FS 4144-7 SLGSafeSM TEMPLATE WORKSHEET
Size: 224 K Uploaded 01/08/2024
FS 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.
Size: 465 K Uploaded 08/17/2018
FS 5238 REQUEST FOR REDEMPTION OF US TREASURY
SECURITIES – SLGS ONE-DAY CERTIFICATE OF INDEBTEDNESS
Redeeming a SLGS one-day Certificate of Indebtedness/Demand Deposit.
Size: 444 K Uploaded 08/17/2018

FS 5377

US TREASURY SECURITIES SLGS EARLY REDEMPTION REQUEST
Size: 221 K Uploaded 08/17/2018
Tax and Loss Bonds (NOT FOR SAVINGS BONDS)
Form Number Title, Description, Size
FS 3871 APPLICATION FOR ISSUE OF UNITED STATES
MORTGAGE GUARANTY INSURANCE COMPANY TAX AND LOSS BONDS
Application for purchasing a Tax and Loss Bond.
Size: 713K Uploaded 03/04/2016
THIS IS NOT A SAVINGS BOND FORM

SLGSafe Form Instructions

4144-5: Application for Internet Access

This form is required in the following circumstances:

  • For every new organization,
  • New organization business address,
  • Changes to existing organization's name and/or organization business address,
  • New Administrators/Backup Administrators, and
  • Change to Administrators/Backup Administrators.

Page one:

  • Ensure that you have read and understand the requirements of gaining access to SLGSafe.
  • Select the type of your organization and add the ABA or TIN and type if other is checked.
  • Fill out the information for the business address for your organization. If you need to add users from different addresses, you need to complete a separate form for each address.

Page two:

  • Provide information for access administrator including e-mail address. This is also the place to add a backup access administrator (not required but highly recommended).
  • Sign and date the form (electronic signatures are acceptable).

4144-6: User Acknowledgement

This form is required for every new user.

  • The organization information should be entered in the first paragraph.
  • The user should sign and date the form (electronic signature is acceptable).

4144-7: Template Worksheet

This form is optional. The access administrator needs to completely fill out only the areas of the form that the organization wants included on all their SLGS cases.