Forms, Instructions and Information
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Contact Information
-
Rudy Burgess
Voice: (804) 225-3051
Email: AcctsRecv@doa.virginia.gov
- 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
Contact Information
-
Amanda Simpson, CFE, Director
Voice: (804) 371-8912
Email: ComplianceAssurance@doa.virginia.gov
- Authorized Signatories Form (DA-04-121) [DocuSign PDF]
Cash Management Improvement Act
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.
Contact Information
- Voice: (804) 786-0874
Email: cca@doa.virginia.gov
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
- Annual Exceptions [Word]
Applications
- Charge Card Agency Airline Travel Card (ATC) Request Form [PDF] [Word]
- Purchasing Charge Card Request Form [PDF] [Word]
- Gold Card Request Form [PDF] [Word]
Cardholder Agreements
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
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
- Cardinal Project Website
- Commonwealth Vendor Group Frequently Asked Questions [PDF]
- Virginia's e-Procurement Portal (eVA)
Contact Information
- Hotline: (804) 225-2564
- Email: cds@doa.virginia.gov
Comptroller’s Debt Setoff (CDS)
- Payment Withdrawal From Comptroller’s Debt Setoff Request [PDF]
Contact Information
- Email: disb@doa.virginia.gov
Treasury Offset Program (TOP)
- TOP Reversal Request [PDF]
Contact Information
-
Hotline: (804) 692-0473
Email: Inquiries only
edi@doa.virginia.govMailing Address:
Department of Accounts
EDI Unit
PO Box 1971
Richmond, VA 23218-1971
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
- Cardinal Non-State Employee EDI Enrollment Form [PDF]
- Cardinal Board Member EDI Form [PDF]
- EDI More Information
Contact Information
-
Melinda L. Pearson, CPA, Director
Voice: (804) 225-2376
Email: Certification@doa.virginia.gov
Fax: (804) 225-4250
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
Contact Information
-
Susan Jones, Director
Voice: (804) 225-2414
Email: faacs@doa.virginia.gov
Fax: (804) 225-2430
- 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]
Contact Information
-
Susan Jones, Director
Voice: (804) 225-2414
Email: las@doa.virginia.gov
Fax: (804) 225-2430
Moving and Relocation
Contact Information
-
For compliance related questions:
Email: ComplianceAssurance@doa.virginia.gov -
For payroll related questions:
Email: payroll@doa.virginia.gov
Contact Information
-
Cathy McGill, Director
Voice: (804) 225-2245
Email: payline@doa.virginia.gov
Fax: (804) 225-3499
Contact Information
-
Cathy McGill, Director
Voice: (804) 225-2245
Email: payline@doa.virginia.gov
Fax: (804) 225-3499
- Payline/PAT Security Authorization Request Form [DocuSign PDF]
Payroll Operations
Contact Information
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
- 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 9/15/2023
Electronic Filing Forms
- Form 8655 - Reporting Agent Authorization for Magnetic Tape / Electronic Filers:
- Form with Instructions [PDF]
Healthcare
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 [Excel] - Revised September 14, 2023
- HCM Direct Deposit Reversal [Excel] - Revised September 14, 2023
- 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
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
- Optional Life Premium Calculation Worksheet
VRS/Minnesota Life On-Line Forms
Miscellaneous Forms
- COV Mobile Device Allowance Agreement Form [PDF]
- Creditable Compensation Form [Excel]
- GLI Default Coding [PDF] [Word] - Revised August 2023
- 2023 Maximum Deferral Calculations
[Excel]
- Revised March 10, 2023
- Excel must be closed before opening this spreadsheet to avoid error messages. - Post Retirement Life Insurance Calculation Worksheet for ORP Retirees [Excel] - Revised October 24, 2014
- Social Security Number Correction Request [Excel]
- SPO SharePoint Security Authorization Request [PDF]
- Out of State Taxing Matrix [PDF]
- VRS Modernization Working Examples [PDF]
Payroll Processing Forms
Quarterly Reconciliation Forms
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.
Void Forms
- Void Check Form (PR-2) [PDF]
Contact Information
-
Penny Williams
Voice: (804) 225-3804
Email: PromptPay@doa.virginia.gov
Contact Information
-
Carmelita Holmes
Voice: (804) 371-7800
Email: payroll@doa.virginia.gov
Fax: (804) 225-3499
Security Authorization Request Forms
Manuals
Travel Forms
Contact Information
- Travel Expense Reimbursement Voucher (DA-02-041A)
- [Excel 2023 rate Effective 1/1/23]
- [Excel 2022 rate Effective 7/1/22]
- [Excel 2022 rate 1/1/22 - 6/30/22]
Treasury Loans
Contact Information
-
Email: gacct@doa.virginia.gov
Fax: (804) 225-4250
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.
