Forms, Instructions and Information

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Accounts Receivable

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Contact Information

  • Accounts Receivable On-line Application Users Guide [PDF]
  • Accounts Receivable Security Authorization Request - [PDF]
  • Accounts Receivable Summary Report Form [Excel]
  • Office of the Attorney General - Agency Debt Discharge Request [Excel]
  • Office of the Attorney General - Division of Debt Collection - Collection Procedures [PDF]

Authorized Signatories

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Contact Information

Cash Management Improvement Act

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Contact Information

Penny B. Williams
Indirect Cost Coordinator
Voice: (804) 225-3804
Email: cmia@doa.virginia.gov
or Penny.Williams@doa.virginia.gov
Fax: (804) 225-4250

Title 31 U.S.C (the Cash Management Improvement Act of 1990) imposes on the states a responsibility to develop and negotiate agreements governing the flow of cash from the U.S. Treasury to the Commonwealth. Careful analysis and monitoring of this program is critical due to the interest penalty that accrues for the time that a state agency holds federal cash.

  • 2017 CMIA Treasury-State Agreement [PDF]
  • CMIA Interest Calculation and Reporting Instructions [PDF]
  • CMIA Program Component Profile [PDF]
  • CMIA Worksheet for Interest Calculations [Excel]

Charge Card Administration

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Contact Information

Access Requests

  • Agency Electronic Bill Request Form [Word]
  • Program Administrator Form - State Agencies [PDF]
  • Program Administrator Form - Psub [PDF]
  • Works Access Request Form [PDF] [Word]

Annual Exceptions

Applications

Cardholder Agreements

  • Agency Airline Travel Card (ATC) Employee Agreement [PDF] [Word]
  • Employee Paid (Individual Liability) Travel Card Employee Agreement [PDF] [Word]
  • Gold Card Employee Agreement [PDF] [Word]
  • Purchasing Card Employee Agreement [PDF] [Word]

Miscellaneous Forms

Request Forms available through the:

Online Application
  • Annual Cardholder Review Certification Form
  • Annual Training Certification Form
  • Permanent Credit Limit Increase Request Form
  • Temporary Credit Limit Increase Request Form
  • Temporary Restriction Removal Request Form
  • Request to Pay Past Due Invoices

Commonwealth Vendor Group

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Contact Information

Email: cvg@doa.virginia.gov

Cardinal Vendor Forms and Job Aids

  • Agency Signature Authorization for Vendor Maintenance [Word]
  • Commonwealth of Virginia Substitute W-9 [PDF]
  • Online Submission of Vendor Maintenance Request Form [PDF]
  • Vendor Maintenance Request Form [Word]
  • Vendor Maintenance Request Form Instructions [PDF]
  • Vendor Processing Job Aid [PDF]
  • Vendor Lien Job Aid [PDF]

Additional Information

Comptroller's Debt Setoff (CDS)

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Contact Information

  • Payment Withdrawal From Setoff Request [PDF]

Electronic Data Interchange (EDI)

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Contact Information

EDI User Guide [PDF]

REDI Virginia User’s Guide [PDF]

Discontinued Direct Deposit in CIPPS User's Guide [PDF]

EDI forms must be mailed. Do not send EDI forms via e-mail.

Trading Partner

  • Trading Partner EDI Agreement and Enrollment Form for Localities and Grantees [PDF]
  • Trading Partner EDI Agreement and Enrollment Form for Non-State Agencies [PDF]
  • Trading Partner EDI Agreement and Enrollment Form for State Agencies [PDF]
  • Trading Partner EDI Agreement and Enrollment Form for Vendors [PDF]
  • Trading Partner EDI Notification of Change [PDF]

State Employee

  • Cardinal State Employee EDI Enrollment Form [PDF]
  • State Agency EDI Memorandum of Understanding [PDF]
  • Discontinued Direct Deposit in CIPPS [PDF]

Other

Financial Certification

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Contact Information

State Agencies

  • Financial Certification Website - Memorandum dated April 4, 2012 [PDF]
  • Financial Certification Administrative Manual - State Agency [PDF]
  • Financial Certification Security Maintenance Form - State Agency [PDF]

Local Treasurers

  • Financial Certification Website - Memorandum dated April 4, 2012 [PDF]
  • Financial Certification Administrative Manual - Treasurers [PDF] [Word]
  • Financial Certification Security Maintenance Form - Treasurers [PDF]

Clerks of the Circuit Court

  • Financial Certification Website - Memorandum dated April 4, 2012 [PDF]
  • Financial Certification Administrative Manual - Clerks [PDF] [Word]
  • Financial Certification Security Maintenance Form - Clerks [PDF]

Fixed Asset Accounting and Control

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Contact Information

  • CIP Documentation Worksheet [Excel]
  • FAACS Authorized Signatures (FAACS-S3) [PDF] [Word]
  • FAACS Logon Request Form (FAACS-S1) [PDF] [Word]
  • Financial and Voucher Information Form (Basis Input) (FAACS12) [PDF]
  • Location and Responsibility Form (Basis Input) (FAACS11) [PDF]
  • Nomenclature List [Excel]
  • Nomenclature Table Specification Form (FAACS 83) [Excel]
  • Online Form to Reset Password (FAACS-S2) [PDF] [Word]
  • Optional Form (FAACS13) [PDF]
  • Steps to Requesting Access for FAACS [PDF]

Lease Accounting Forms

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Contact Information

  • Steps to Requesting Access for LAS Plus [PDF]
  • Lease Accounting System (LAS Plus) Security Access Form (LAS Plus-S1) [PDF] [Word]
  • Lease Authorized Signatures (LAS Plus-S3) [PDF] [Word]
  • LAS Plus GASB 87 Interface Layout [Excel]
  • LAS Plus SBITA Interface Layout [Excel]

Moving and Relocation

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Contact Information

  • Employee Moving and Relocation Expense Information [Excel]
  • Tenure Agreement Form [PDF]

Payline

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Contact Information

Payline/PAT

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Contact Information

Payroll Operations

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Contact Information

Cathy McGill, Director
Voice: (804) 225-2245
Email: Cathy.McGill@doa.virginia.gov
Fax: (804) 225-3499
Payroll Email Address: payroll@doa.virginia.gov

Calculation Spreadsheets

  • Adjusted Employment Date Calculator [Excel]
  • Administrative Wage Garnishment Spreadsheet [Excel]
  • Healthcare ATA Checker [Excel] (save spreadsheet to your local drive to allow macros to run)
  • Leave Payment Spreadsheet [Excel]
  • Net Sick Leave Payout Calculations for Estimate of Purchase of Service Months [Excel]
  • Non-VSDP Worker's Comp Calculations [Excel]
  • Partial Pay Calculations [Excel] Updated 09/18/2018
  • Post Retirement Life Insurance Calculation Worksheet for ORP Retirees [Excel]
  • Retirement Overrides [Excel] Updated 10/28/2020
  • Semi-Monthly Overtime Calculations [Excel]
  • TWFR Retirement calc ww [Excel]
  • VRS Automated Recon Spreadsheet [Excel]
  • VSDP Calculations [Excel] Updated 08/31/2020
  • VSDP Intermittent W/C Spreadsheet [Excel]
  • Wage Chart (VWC 7A) [Excel] Updated 10/3/2022

Electronic Filing Forms

  • Form 8655 - Reporting Agent Authorization for Magnetic Tape / Electronic Filers:
    • Form with Instructions [PDF]

Healthcare

Leave Forms

  • Leave Balance Spreadsheet [PDF] [Excel]
  • L-1 - Leave Activity Reporting Form [PDF] [Word]
  • L-2 - Leave Maintenance Form [PDF]
  • L-3 - Leave Activity/Maintenance Batch Totals Form [PDF]
  • L-4 - Leave Status Inquiry/Update Form [PDF] [Word]
  • L-5 - General CIPPS Leave Information Form [PDF] [Word]

HCM Forms

  • Agency HCM Payroll Certification [PDF]
  • Balance Adjustments Request Form [Excel] - Revised March 29, 2022
  • Update Paysheets Request Form [Excel] - Revised March 27, 2023
  • HCM Check Reversal Form [PDF]
  • HCM Direct Deposit Reversal [Excel]
  • HCM FLSA Calculator [Excel] - Revised February 3, 2023
  • HCM Agency Repayment - Reversal Request [Excel] - Revised March 27, 2023
  • HCM VSDP Calculations [Excel]
  • FICA Gross-Up for Terminated Employees [Excel]
  • Fiscal Officer Proxy form [DocuSign PDF]
  • Report Crosswalk [Excel]
  • Virginia Way2Go Card Debit Mastercard Authorization Form [PDF] - Revised February 2019

Magnetic Media

  • Magnetic Media Requirements - 700 - Pay Transactions (Standard Time Reporting) [PDF]
  • Magnetic Media Requirements - 8XX - Tax and Deduction Overrides [PDF]
  • Magnetic Media Requirements - 9XX - Pay Transactions (Special Payments) [PDF]
  • Magnetic Media Requirements - IBC - Batch Balance [PDF]
  • Security Batch Transaction Request [PDF] [Word]

Miscellaneous Insurances and Annuities

  • 403(b) 15-Year Catch Up - (04/06/2022) [PDF]
  • Cash Match Agreement Form - (01/2019) [PDF]
  • Miscellaneous Insurances Information - (01/2019) [PDF]
  • Miscellaneous Insurances/Annuities Admin Manual - (01/2019) [PDF]
  • Post-Tax Salary Deduction Authorization - (01/2019) [PDF]
  • Pre-Tax Salary Reduction Agreement Form - (01/2019) [PDF]
  • Tax Sheltered Annuities - (01/2019) [PDF]
  • TPA Employment Status Change Form - (01/2019) [PDF]
  • TPA Exception/Discrepancy Response Form - (01/2019) [PDF]

Optional Group Life Forms

Miscellaneous Forms

  • Cardinal Automated Reconcilation Default Coding [PDF] [Word]
  • COV Mobile Device Allowance Agreement Form [PDF]
  • Creditable Compensation Form [Excel]
  • GLI Default Coding [PDF] [Word]
  • 2023 Maximum Deferral Calculations [Excel] - Revised March 10, 2023
    - Excel must be closed before opening this spreadsheet to avoid error messages.
  • PMIS to CIPPS Automated Update Process - Salaried [Excel]
  • PMIS to CIPPS Automated Update Process - Wage [Excel]
  • Post Retirement Life Insurance Calculation Worksheet for ORP Retirees [Excel] - Revised October 24, 2014
  • Report Writer Matrix [Excel]
  • Request to Add Garnishment Vendor/Payee [Excel]
  • Social Security Number Correction Request [Excel]
  • SPO SharePoint Security Authorization Request [PDF]
  • Temporary Number Request [Excel]
  • Out of State Taxing Matrix [PDF]
  • VRS Modernization Working Examples [PDF]
  • VEC Web Upload Excel Template [Excel]

Payroll Processing Forms

Quarterly Reconciliation Forms

  • Agency Request for W-2C [Excel] - Revised March 27, 2023
  • Cardinal Quarterly Certification Form [Excel]
  • W-2 Distribution Form 2022 [Excel] - Revised December 28, 2022

Statewide Special Pay Forms

  • CIPPS Standard Special Pay Codes [PDF]
  • Statewide Special Pay Codes - Examples of Combinations of Indicators [PDF]

Statewide Deductions

  • Maximum Deferral Calculation Spreadsheets for Special Pays [Excel] - Revised April 26, 2020
    - Excel must be closed before opening this spreadsheet to avoid error messages.
  • Statewide Deduction Codes - Matrix of Deduction Codes [Excel] - Revised May 13, 2021

Void Forms

  • Void Check Form (PR-2) [PDF]

Prompt Payment

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Contact Information

  • Prompt Payment On-line Application Users Guide [PDF] [Word]
  • Prompt Payment On-line Application Security Authorization Request [PDF]
  • Prompt Payment Excel Spreadsheet Shell [Excel]

Reportline

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Contact Information

Security Authorization Request Forms

  • Reportline Security Authorization Request Form [PDF] [Word] - Revised 3/1/2013

Manuals

  • Reportline Agency Security Officer Manual [PDF] - Revised 5/17/2017
  • Reportline User Manual [PDF] - Revised 10/18/2011

Travel Forms

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Contact Information

CAPP Manual - Travel Regulations and Policies

Treasury Loans

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Contact Information

Loan, Line of Credit and Grant Coordination

The Appropriation Act provides for intra-governmental loans and lines of credit from the Treasury to support state programs that are anticipating nongeneral funds from federal grants and contracts, bond sales, and similar situations. This subactivity also includes the processing of state grants to nonstate agencies as authorized by the Appropriation Act and regulated by DPB.

  • Treasury Loan Request Form (TL-01) [PDF]
  • Treasury Loan Takedown Request Form (TL-03) [PDF]