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Deparment of Accounts Forms - Form Name Order

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Form Formats Functional Area
Accounting Voucher [PDF] [Excel] General Accounting - Expenditure Forms
Accounts Receivable Security Authorization Request [PDF] [Word] Accounts Receivable
Accounts Receivable Summary Report Form [Excel] Accounts Receivable
Agency Authorization for Certification of Payrolls [PDF] [Excel] Payroll Operations - Payroll Processing
Agency Electronic Bill (eBill) Access Form [PDF] [Word] Charge Card Administration
Agency Transaction Voucher (DA-06-152) [PDF] [Excel] Intra-Agency Transactions
Agency Travel Card Application (Airline Travel Card Application) [PDF] Charge Card Admin - Travel Charge Card
Agency Travel Card Log [PDF] [Excel] Charge Card Admin - Travel Charge Card
Annual Cardholder Review Certification [PDF] [Word] Charge Card Admin - Travel Charge Card
Annual Supervisor/Reviewer Training Certification [PDF] [Word] Charge Card Admin - Purchase Charge Card
Annual Travel Cardholder Training Certification [PDF] [Word] Charge Card Admin - Travel Charge Card
Authorized Signatories Form (DA-04-121) [PDF] [Excel] General Accounting - Security Forms
Authorized Signatures (FAACS-S3) [PDF] [Word] Fixed Asset Accounting and Control
Batch Header (DA-02-176) [PDF] [Excel] General Accounting - Expenditure Forms
Benefits Administrator Approval Form [PDF] Third Party Administrator
CARS Security Table Maintenance Form (DA-04-197) [PDF] General Accounting - Security Forms
Cash Match Agreement Form [PDF] Third Party Administrator
CIPPS Security Authorization Request [PDF] Payroll Operations - CIPPS Security
Claim for Death Benefits [PDF] Line of Duty
Claim for Disability Benefits [PDF] Line of Duty
Classification Test Information (LAS-2) [PDF] [Word] Lease Accounting
Confirmation of Agency Reconciliation to CARS Reports - Security Maintenance Form [PDF] Confirmation of Agency Reconciliation to CARS Reports
Confirmation of Locality Reconciliation to DOA Reports [PDF] [Word] Local Treasurers
COV Agency Travel Card Employee Agreement [PDF] Charge Card Admin - Travel Charge Card
COV Corporate Travel Card Employee Agreement [PDF] [Word] Charge Card Admin - Travel Charge Card
Direct Deposit Authorization for Employees [PDF] Payroll Operations - Direct Deposit
Direct Deposit Stop Payment Form (PR-1) [PDF] Payroll Operations - Direct Deposit
Direct Deposit Stop Payment Form (PR-1) [PDF] Payroll Operations - Voids
Distribution Continuation Sheet (DA-02-038A) [PDF] [Excel] General Accounting - Expenditure Forms
Employee Moving and Relocation Expense Information [PDF] [Excel] Moving and Relocation
Annual Multiple Card Cardholder Certification [PDF] [Excel] Charge Card Admin - Purchase Charge Card
Financial and Voucher Information Form (Basis Input) (FAACS12) [PDF] Fixed Asset Accounting and Control
FINDS 3.0 Security Request (DBAF001) [PDF] Information Resource Management
Flexible Reimbursement Account Election Form [PDF] Third Party Administrator
Flexible Spending Account - Reimbursement Request Form [PDF] Third Party Administrator
GE MasterCard Employee Agreement [PDF] [Word] Charge Card Admin - Purchase Charge Card
GE MasterCard Program Administrator Form [PDF] [Word] Charge Card Administration
H0901 - Third Party Deduction Name and Address (PR-11) [PDF] Payroll Operations - Payroll Processing
Healthcare Adjustments Worksheet [PDF] [Excel] Payroll Operations - Healthcare
Healthcare Certification Form [PDF] Payroll Operations - Healthcare
HTM00 - Manual Pay/Earnings Update (PR-10.1) [PDF] Payroll Operations - Payroll Processing
HTMCK - Manual Pays 5 - Screenprint [PDF] Payroll Operations - Payroll Processing
HTMPA - Manual Pays 2 (PR-10.2) [PDF] Payroll Operations - Payroll Processing
HTMSP - Manual Pays 3 (PR-10.3) [PDF] Payroll Operations - Payroll Processing
HTMTD - Manual Pays 4 (PR-10.4) [PDF] Payroll Operations - Payroll Processing
HTODA - Deduction Refund/Adjustment (PR-7) [PDF] Payroll Operations - Payroll Processing
HTPSA - Employee Special Pay Adjustment (PR-6) [PDF] Payroll Operations - Payroll Processing
HTQTA - Tax Refund/Adjustment (PR-8) [PDF] Payroll Operations - Payroll Processing
HUA03 - Time and Attendance (PR-3) [PDF] Payroll Operations - Payroll Processing
HUC01 - Special Payment as Regular Pay (PR-4) [PDF] Payroll Operations - Payroll Processing
HUD01 - Deduction Override (PR-9) [PDF] Payroll Operations - Payroll Processing
HUE01 - Special Payments (PR-5) [PDF] Payroll Operations - Payroll Processing
Individual Travel Card Application (COV GE Travel Application) [PDF] Charge Card Admin - Travel Charge Card
Interagency Transfer Invoice (DA-02-039) [PDF] [Excel] Intra-Agency Transactions
L-1 - Leave Activity Reporting Form [PDF] Payroll Operations - Leave
L-2 - Leave Maintenance Form [PDF] Payroll Operations - Leave
L-3 - Leave Activity/Maintenance Batch Totals Form [PDF] Payroll Operations - Leave
L-4 - Leave Status Inquiry/Update Form [PDF] [Word] Payroll Operations - Leave
L-5 - General CIPPS Leave Information Form [PDF] Payroll Operations - Leave
Lease Deletion/Termination/Extension Request (LAS-4) [PDF] [Word] Lease Accounting
Lease Report Request (LAS-5) [PDF] [Word] Lease Accounting
Lease Transactions Package - General Lease Information (LAS-1) [PDF] [Word] Lease Accounting
Leave Balance Spreadsheet [PDF] [Excel] Payroll Operations - Leave
Location and Responsibility Form (Basis Input) (FAACS11) [PDF] Fixed Asset Accounting and Control
Logon Request Form (FAACS-S1) [PDF] [Word] Fixed Asset Accounting and Control
Magnetic Media Requirements - 700 - Pay Transactions (Standard Time Reporting) [PDF] Payroll Operations - Magnetic Media
Magnetic Media Requirements - 8XX - Tax and Deduction Overrides [PDF] Payroll Operations - Magnetic Media
Magnetic Media Requirements - 9XX - Pay Transactions (Special Payments) [PDF] Payroll Operations - Magnetic Media
Magnetic Media Requirements - IBC - Batch Balance [PDF] Payroll Operations - Magnetic Media
Online Form to Reset Password (FAACS-S2) [PDF] [Word] Fixed Asset Accounting and Control
Optional Form (FAACS13) [PDF] Fixed Asset Accounting and Control
Payline Agency Contact Form [PDF] [Word] Payline
Payline Security Authorization Request Form [PDF] [Word] Payline
Payment Stream Information (LAS-3) [PDF] [Word] Lease Accounting
Payment Withdrawal From Setoff Request [PDF] [Word] Comptroller's Debt Setoff
Petty Cash Expense Reimbursement Voucher [PDF] [Excel] General Accounting - Expenditure Forms
Post Retirement Life Insurance Calculation Worksheet for ORP Retirees [Excel] Payroll Operations - Payroll Processing
Post-Tax Salary Deduction Authorization [PDF] Third Party Administrator
Pre-Tax Salary Reduction Agreement Form [PDF] Third Party Administrator
Prompt Payment Security Authorization Request [PDF] [Word] Financial Reporting - Prompt Payment Forms
Prompt Payment Excel Spreadsheet Shell [PDF] Financial Reporting - Prompt Payment Forms
Purchase Card Log [PDF] [Excel] Charge Card Admin - Purchase Charge Card
Purchase Cardholder Training Certification [PDF] [Word] Charge Card Admin - Purchase Charge Card
Purchasing Card Request Form [PDF] [Word] Charge Card Admin - Purchase Charge Card
Quarterly Reconciliation - Employee File Adjustment Form [PDF] Payroll Operations - QTR & YR Recon
Quarterly Reconciliation and Certification Form [PDF] Payroll Operations - QTR & YR Recon
Reporting Agent Authorization for Magnetic Tape / Electronic Filers - Form 8655 with Instructions [PDF] Payroll Operations - Electronic Filing
Reportline Locality Security Authorization Request Form [PDF] [Word] Reportline
Reportline Security Authorization Request Form [PDF] Reportline
Revenue Refund Voucher (DA-02-181) [PDF] [Excel] General Accounting - Revenue Refund Forms
Security Batch Transaction Request (S-3) [PDF] [Word] Payroll Operations - Magnetic Media
Annual Purchase Card Review Certification [PDF] [Word] Charge Card Admin - Purchase Charge Card
State Agency EDI Memorandum of Understanding [PDF] [Word] Electronic Data Interchange (EDI)
State Employee EDI Enrollment Form [PDF] Electronic Data Interchange (EDI)
State Employee EDI Notification of Change [PDF] [Word] Electronic Data Interchange (EDI)
Statewide Deduction Codes - Matrix of Deduction Codes [PDF] Payroll Operations - Statewide Deductions
Statewide Special Pay Codes - Examples of Combinations of Indicators [PDF] Payroll Operations - Statewide Special Pays
Statewide Special Pay Codes - Matrix of Special Pay Codes [PDF] Payroll Operations - Statewide Special Pays
Strategic Account Management (SAM) Reporting Request [PDF] [Word] Charge Card Administration
Supervisor/Reviewer Checklist [PDF] Charge Card Admin - Purchase Charge Card
Tenure Agreement Form [PDF] Moving and Relocation
TPA Employment Status Change Form [PDF] Third Party Administrator
TPA Exception/Discrepancy Response Form [PDF] Third Party Administrator
Trading Partner EDI Agreement and Enrollment Form for Localities and Grantees [PDF] Electronic Data Interchange (EDI)
Trading Partner EDI Agreement and Enrollment Form for Non-State Agencies [PDF] Electronic Data Interchange (EDI)
Trading Partner EDI Agreement and Enrollment Form for State Agencies [PDF] Electronic Data Interchange (EDI)
Trading Partner EDI Agreement and Enrollment Form for Vendors [PDF] Electronic Data Interchange (EDI)
Trading Partner EDI Notification of Change [PDF] [Word] Electronic Data Interchange (EDI)
Travel Expense Reimbursement Voucher (DA-02-041A) [PDF]
[Excel 2007 rate]
[Excel 2008 rate]
Travel Forms
Treasury Loan Request (TL-01) [PDF] Treasury Loans
Treasury Loan Takedown Request (TL-03) [PDF] Treasury Loans
U118 - Gross Pay Difference Explanation [PDF] [Excel] Payroll Operations - Payroll Processing
Void Check Form (PR-2) [PDF] Payroll Operations - Voids
Worksheet for Interest Calculations [Excel] Cash Management Improvement Act
Year End Certification - Employee File Adjustment Form [PDF] Payroll Operations - QTR & YR Recon
Year End Reconciliation and Certification Form [PDF] Payroll Operations - QTR & YR Recon