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 |