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Department 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
Adjusted Employment Date Calculator [Excel] Payroll Operations - Calculation Spreadsheets
Administrative Wage Garnishment Spreadsheet [Excel] Payroll Operations - Calculation Spreadsheets
Agency Airline Travel Card (ATC) Employee Agreement [PDF] [Word] Charge Card Administration
Agency Airline Travel Card (ATC) Request Form [PDF] [Word] Charge Card Administration
Agency Authorization for Certification of Payrolls [PDF] [Excel] Payroll Operations - Payroll Processing
Agency Electronic Bill Request Form [PDF] [Word] Charge Card Administration
Agency Transaction Voucher (DA-06-152) [PDF] [Excel] Intra-Agency Transactions
Agency Travel Card Log [PDF] [Excel] Charge Card Administration
Annual Cardholder Review Certification Form [PDF] [Word] Charge Card Administration
Annual Exceptions [PDF] [Word] Charge Card Administration
Annual Training Certification Form [PDF] [Word] Charge Card Administration
Authorized Signatories Form (DA-04-121) [PDF] [Excel] General Accounting - Security Forms
Batch Header (DA-02-176) [PDF] [Excel] General Accounting - Expenditure Forms
Cardinal State Employee EDI Enrollment Form [PDF] Electronic Data Interchange (EDI)
CARS Security Table Maintenance Form (DA-04-197) [PDF] General Accounting - Security Forms
CARS Security Table Maintenance Form (DA-04-197) Instructions [PDF] General Accounting - Security Forms
CARS FINDS Security Authorization Request Form [PDF] General Accounting - Security Forms
CARS FINDS Security Authorization Request Form Instructions [PDF] General Accounting - Security Forms
Cash Match Agreement Form [PDF] Third Party Administrator
CIP Documentation Worksheet [Excel] Fixed Asset Accounting and Control
CIPPS Company Add/Maintenance (PR-12) [PDF] [Word] Payroll Operations - Payroll Processing
CIPPS Security Authorization Request [PDF] [Word] Payroll Operations - CIPPS Security
CIPPS FINDS Security Authorization Request Form [PDF] [Excel] Payroll Operations - CIPPS Security
CIPPS FINDS Security Form Instructions [PDF] [Word] Payroll Operations - CIPPS Security
CIPPS Standard Special Pay Codes [PDF] Payroll Operations - Statewide Special Pays
Claim for Death Benefits [PDF] Line of Duty
Claim for Disability Benefits [PDF] Line of Duty
CMIA Program Component Profile [PDF] Cash Management Improvement Act
CMIA Worksheet for Interest Calculations [Excel] Cash Management Improvement Act
Confirmation of Locality Reconciliation to DOA Reports [PDF] [Word] Local Treasurers
COV Mobile Device Allowance Agreement Form [PDF] Payroll Operations - Miscellaneous Forms
Direct Deposit Authorization for Employees [PDF] Payroll Operations - Direct Deposit
Direct Deposit Stop Payment Form (PR-1) [PDF] [Word] Payroll Operations - Direct Deposit
Payroll Operations - Voids
Distribution Continuation Sheet (DA-02-038A) [PDF] [Excel] General Accounting - Expenditure Forms
Employee Paid (Individual Liability) Travel Card Employee Agreement [PDF] [Word] Charge Card Administration
Employee Moving and Relocation Expense Information [PDF] [Excel] Moving and Relocation
Error Correction Request Automated Form [PDF] General Accounting - Error Correction
Error Correction Instructions Summary [PDF] General Accounting - Error Correction
FAACS Authorized Signatures (FAACS-S3) [PDF] [Word] Fixed Asset Accounting and Control
Financial and Voucher Information Form (Basis Input) (FAACS12) [PDF] Fixed Asset Accounting and Control
Financial Certification - Security Maintenance Form - State Agency [PDF] Financial Certification
Financial Certification - Security Maintenance Form - Locality [PDF] Financial Certification
Fixed Asset Accounting and Control System (FAACS) Security Access Form [PDF] [Word] Fixed Asset Accounting and Control
GLI and Health Care Default Coding [PDF] [Word] Payroll Operations - Miscellaneous Forms
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
Interagency Transfer Invoice (DA-02-039) [PDF] [Excel] Intra-Agency Transactions
L-1 - Leave Activity Reporting Form [PDF] [Word] 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 Accounting System (LAS) Security Access Form (LAS-S1) [PDF] [Word] Lease Accounting
Lease Classification Test Information (LAS-2) [PDF] [Word] Lease Accounting
Lease Deletion/Termination/Extension Request (LAS-4) [PDF] [Word] Lease Accounting
Lease Payment Stream Information (LAS-3) [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
FAACS Location and Responsibility Form (Basis Input) (FAACS11) [PDF] Fixed Asset Accounting and Control
FAACS Logon Request Form (FAACS-S1) [PDF] [Word] Fixed Asset Accounting and Control
FAACS Online Form to Reset Password (FAACS-S2) [PDF] [Word] Fixed Asset Accounting and Control
FAACS Optional Form (FAACS13) [PDF] 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
Maximum Deferral Calculation Spreadsheets for Special Pays [Excel] Payroll Operations - Calculation Spreadsheets
Mobile Device Allowance Agreement Form [PDF] Payroll Operations - Miscellaneous Forms
Payline Agency Contact Form [PDF] [Word] Payline
Payline/PAT Security Authorization Request Form [PDF] [Word] Payline/PAT
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
Program Administrator Form [PDF] [Word] Charge Card Administration
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 Administration
Purchasing Card Employee Agreement [PDF] [Word] Charge Card Administration
Purchasing Charge Card Request Form [PDF] [Word] Charge Card Administration
Quarterly Reconciliation - Employee File Adjustment Form [PDF] Payroll Operations - Quarterly Reconciliations
Quarterly Reconciliation and Certification Form [PDF] Payroll Operations - Quarterly Reconciliations
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 Non-Locality Security Authorization Request Form [PDF] [Word] 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
State Agency EDI Memorandum of Understanding [PDF] Electronic Data Interchange (EDI)
State Employee EDI Enrollment Form [PDF] Electronic Data Interchange (EDI)
Statewide Deduction Codes - Matrix of Deduction Codes [PDF] [Excel] Payroll Operations - Statewide Deductions
Statewide Special Pay Codes - Examples of Combinations of Indicators [PDF] Payroll Operations - Statewide Special Pays
Supervisor/Reviewer Checklist [PDF] [Word] Charge Card Administration
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] Electronic Data Interchange (EDI)
Travel Expense Reimbursement Voucher (DA-02-041A) [PDF]
[Excel 2014 rate]
[Excel 2011 rate]
[Excel 2013 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
Vendor Maintenance Request Form [PDF] Commonwealth Vendor Group
Vendor Maintenance Request Form Job Aid [PDF] Commonwealth Vendor Group
Void Check Form (PR-2) [PDF] Payroll Operations - Voids
Works Access Request Form [PDF] [Word] Charge Card Administration