Forms - Virginia Department of Accounts
(804) 225-3038

Virginia Department of Accounts

Financial Accountability. Reporting Excellence.

Forms, Instructions and Information

Page Navigation

Accounts Receivable

Top of page

Online Application

Contact Information

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

Authorized Signatories

Top of page

Contact Information

Cash Management Improvement Act

Top of page

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

Top of page

Online Application

Contact Information

Access Requests

Annual Exceptions

Applications

Cardholder Agreements

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

Miscellaneous Forms

Request Forms available through the Online Application:

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

Commonwealth Vendor Group

Top of page

Online Application

Contact Information

HOTLINE: (804) 692-0473
Email: cvg@doa.virginia.gov
Fax: (804) 371-8587

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)

Top of page

Contact Information

Electronic Data Interchange (EDI)

Top of page

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

Top of page

Online Application

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

Top of page

Online Application

Contact Information

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

Lease Accounting Forms

Top of page

Online Application

Contact Information

  • Lease Accounting System (LAS) Security Access Form (LAS-S1) [PDF] [Word]
  • Lease Classification Test Information (LAS-2) [PDF] [Word]
  • Lease Deletion/Termination/Extension Request (LAS-4) [PDF] [Word]
  • Lease Payment Stream Information (LAS-3) [PDF] [Word]
  • Lease Report Request (LAS-5) [PDF] [Word]
  • Lease Transactions Package - General Lease Information (LAS-1) [PDF] [Word]
  • Lease Authorized Signatures (LAS-S3) [PDF] [Word]

Moving and Relocation

Top of page

Contact Information

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

Payline

Top of page

Online Application

Contact Information

Payline/PAT

Top of page

Online Application

Contact Information

  • Payline/PAT Security Authorization Request Form [PDF] [Word]

Payroll Operations

Top of page

Contact Information

Cathy McGill, Acting Director
Voice: (804) 371-7800
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 08/05/2016
  • Post Retirement Life Insurance Calculation Worksheet for ORP Retirees [Excel]
  • Retirement Overrides [Excel] Updated 07/17/2018
  • Semi-Monthly Overtime Calculations [Excel]
  • VRS Automated Recon Spreadsheet [Excel]
  • VSDP Calculations [Excel] Updated 08/05/2016
  • VSDP Intermittent W/C Spreadsheet [Excel]
  • Wage Chart (VWC 7A) [Excel]

CIPPS Security Forms

  • CIPPS Security Authorization / Deletion Request Form [PDF] [Word]
  • Fiscal Officer Proxy for Payroll Certifications Form [PDF] [Word]

Direct Deposit Forms

  • Direct Deposit Authorization for Employees [PDF] [Word]
  • Direct Deposit Stop Payment Form (PR-1) [PDF] [Word]
  • Existing Paycard Notification Letter Example [Word]
  • New Paycard Notification Letter Example [Word]
  • Virginia Way2Go Card Debit Mastercard Authorization Form [PDF]

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]

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 Forms

  • Cardinal Automated Reconcilation Default Coding [PDF] [Word]
  • COV Mobile Device Allowance Agreement Form [PDF]
  • GLI Default Coding [PDF] [Word]
  • PMIS to CIPPS Automated Update Process [Excel]
  • Report Writer Matrix [Excel]
  • Request to Add Garnishment Vendor/Payee [Excel]
  • Out of State Taxing Matrix [PDF]
  • VRS Modernization Working Examples [PDF]
  • VEC Web Upload Excel Template [Excel]

Optional Group Life Forms

Miscellaneous Insurances and Annuities

  • 2017 TPA Cut-off Dates [PDF]
  • Miscellaneous Insurances and Annuities FOCUS Meeting - (03/2013) [PDF] [PowerPoint]
  • Cash Match Agreement Form - (03/2017) [PDF]
  • Miscellaneous Insurances Information - (03/2017) [PDF]
  • Post-Tax Salary Deduction Authorization - (03/2017) [PDF]
  • Pre-Tax Salary Reduction Agreement Form - (03/2017) [PDF]
  • Miscellaneous Insurances/Annuities Admin Manual - (03/2017) [PDF]
  • Tax Sheltered Annuities - (03/2017) [PDF]
  • TPA Employment Status Change Form - (03/2017) [PDF]
  • TPA Exception/Discrepancy Response Form - (03/2017) [PDF]

Payroll Processing Forms

  • Agency Authorization for Certification of Payrolls [PDF] [Excel]
  • CIPPS Payroll Processing Forms - Workbook with Multiple Forms [Excel]
  • CIPPS Company Add/Maintenance (PR-12) [PDF] [Word]
  • H0901 - Third Party Deduction Name and Address (PR-11) [PDF]
  • HTM00 - Manual Pay/Earnings Update (PR-10.1) [PDF]
  • HTMCK - Manual Pays 5 - Screenprint [PDF]
  • HTMPA - Manual Pays 2 (PR-10.2) [PDF]
  • HTMSP - Manual Pays 3 (PR-10.3) [PDF]
  • HTMTD - Manual Pays 4 (PR-10.4) [PDF]
  • HTODA - Deduction Refund/Adjustment (PR-7) [PDF]
  • HTPSA - Employee Special Pay Adjustment (PR-6) [PDF]
  • HTQTA - Tax Refund/Adjustment (PR-8) [PDF]
  • HUA03 - Time and Attendance (PR-3) [PDF]
  • HUC01 - Special Payment as Regular Pay (PR-4) [PDF]
  • HUD01 - Deduction Override (PR-9) [PDF]
  • HUE01 - Special Payments (PR-5) [PDF]
  • U118 - Gross Pay Difference Explanation [PDF] [Excel]

Quarterly Reconciliation Forms

  • Quarterly Reconciliation - Employee File Adjustment Form [PDF]
  • Quarterly Reconciliation and Certification Form [PDF]

Statewide Deductions

  • Maximum Deferral Calculation Spreadsheets for Special Pays [Excel] - Revised January 16, 2018.
    - Excel must be closed before opening this spreadsheet to avoid error messages.
  • Statewide Deduction Codes - Matrix of Deduction Codes [PDF] [Excel]

Statewide Special Pay Forms

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

Void Forms

  • Void Check Form (PR-2) [PDF]

Prompt Payment

Top of page

Online Application

Contact Information

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

Reportline

Top of page

Online Application

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

Top of page

Contact Information

CAPP Manual - Travel Regulations and Policies

Treasury Loans

Top of page

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]

Contact Information

Phone Number:

Main: (804) 225-3038
Fax: (804) 371-8587

Street Address:

Department of Accounts
James Monroe Building
101 North 14th Street,
2nd Floor
Richmond VA 23219-3638

Mailing Address:

Department of Accounts
PO Box 1971
Richmond VA 23218-1971

Directions

Map to Departmment of Accounts

About DOA

Online Services

Cardinal Project

Reports

Reference

Forms

A+ A-