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STATE OF WEST VIRGINIA
DEPARTMENT OF ADMINISTRATION AGENCY NAME:
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP CLOSING - TRANSMITTAL FORM 1
DUE JULY 30, 2010
(Original and 1 copy)
THE FOLLOWING GAAP CLOSING FORMS
ARE ATTACHED:
DATE
COMPLETED N/A FORM #
AUDIT NOTIFICATION FORM
CLAIMS, JUDGMENTS / CONTINGENCIES
UNBUDGETED LIABILITIES DISCLOSURE 1
CASH AND INVESTMENTS
OUTSIDE BANK ACCOUNTS SHEET 2A
BANK RECONCILIATION 2B
OUTSIDE BANK ACCOUNT TRANSMITTAL TRANSMITTAL 1A
MATERIALS & SUPPLIES INVENTORY
PHYSICAL INVENTORY ACCUMULATION FORM 3
RECEIVABLES
ACCOUNTS RECEIVABLE 4A
INTRA-AGENCY RECEIVABLE (OTHER AGENCIES) 4B
INTRA-AGENCY RECEIVABLE (COMPONENT UNITS) 4C
INFORMATION SUBMITTED/ENTERED:
COMPENSATED ABSENCES SUBMITTED TO IS&C or FARS: Due 7/09/2010
FIXED ASSETS & INFRASTRUCTURE ENTERED INTO FIMS: Due 7/15/2010
(Equipment $25,000 Buildings $100,000 Infrastructure $0)
OTHER ASSETS & OTHER LIABILITIES
OTHER ASSETS INFORMATION SHEET 5
OTHER LIABILITIES INFORMATION SHEET 6
OPERATING LEASES 7
MULTI-YEAR REVENUE
MULTI-YEAR REVENUE 8
** Form changed from prior year
*** New Form
PLEASE SEND COMPLETED TRANSMITTAL AND
COMPLETED FORMS (Original and 1 copy)
TO:
State of West Virginia
Financial Accounting and Reporting Section
PREPARED BY Building 17, 3rd Floor
2101 Washington Street East
Charleston, WV 25305
AGENCY TELEPHONE NUMBER or email to: Sheila.K.Straley@wv.gov
Telephone Number 304-558-4083
DATE Fax Number 304-558-4084
West Virginia State Treasurer's Office Agency Name: 0
Cash Management Division
Outside Bank Accounts - Transmittal Form
DUE JULY 30, 2010
The following outside bank account forms
are attached:
Date
Completed N/A Form Number
CASH AND INVESTMENTS
Outside Bank Accounts Sheet 2A
Bank Reconciliation 2B
List of Outstanding Checks (Including date, check number, payee, and amount) 2B Attachment
Signature Card - Most Recent N/A
****NEW for FY 2010****
This year the West Virginia State Treasurer's Office is asking all agencies to
submit their end-of-year outside bank information on their new web base
program. To access program log on to
http://apps.wvsto.com/outsidebankaccounts
Prepared By Instructions are included for this process once you are logged in. If you are
a new program user or do not have a user id contact Julie Hefner-Ferrell
with the Treasurer's Office.
Agency Telephone Number
Phone: 304-340-2718
email: julie.hefner-ferrell@wvsto.com
Date
STATE OF WEST VIRGINIA
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
AUDIT NOTIFICATION FORM
This form is to be filled out and sent to FARS any time audit work or review will be performed by independent,
federal or other auditors/reviewers (not legislative audit).
ENTITY NAME: Contact Person:
Period covered:
Auditing/reviewing firm: Contact Person:
Type of engagement:
Government Auditing Standards?
WVFIMS funds examined:
Scheduled completion date:
NOTE: With outside audits - 3 copies of completed audit and representation letter should be sent to FARS.
With Federal audit or review - 2 copies of closing report or letter should be sent to FARS.
Please send this form to:
Prepared By
State of West Virginia
Financial Accounting and Reporting Section
Telephone Number Building 17, 3rd Floor
2101 Washington Street East
Charleston, WV 25305
Date Telephone Number 304-558-4083
Fax Number 304-558-4084
STATE OF WEST VIRGINIA
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - CLAIMS AND JUDGMENTS/CONTINGENCIES
Agency Name: 0 FORM 1
CLAIMS AND JUDGMENTS/CONTINGENCIES/UNBUDGETED LIABILITIES DISCLOSURE FORM
1. PENDING LEGAL CLAIMS
For each contingency in excess of $1,000,000 or $20 million in aggregate regarding pending
or threatened litigation, asserted and unasserted claims and assessments outstanding at
June 30, 2010, or which have arisen since that date, please answer the following questions:
a. List the type of contingency (Gain or Loss) and give a brief description
(i.e. fall down in elevator, police brutality).
b. Select the nature of the matter/cause of action:
Wrongful Death
Civil Rights
Car Accident
Other (Explain)
c. Defenses (select applicable defense)
11th Amendment
Constitutional Immunity
Other Immunity
Other (Explain)
d. List the name(s) of the adverse parties (co-defendants) involved (not the State Agency)
e. Is the claim covered by the Board of Risk and Insurance Management (BRIM)? (BRIM covers up to $1,000,000).
Yes
No
f. Describe the progress of the matter to date
Motion to dismiss filed
Grounds
Discovery
Pending summary judgment motions
Scheduled hearings
If trial date set, give date
g. How is the State/agency responding to or how does the State intend to respond to the
matter (for example, to contest the case vigorously or intends to seek an out-of-court
settlement).
h. Please provide an evaluation of an unfavorable outcome (check one of the following:)
Very Remote 0% to 10%
Remote 11% to 25%
Somewhat Possible 26% to 49%
Reasonably Possible 50/50
Probable 51% to 75%
Very Probable over 75%
and an estimate or range of the potential loss costs.
Amount
What portion will be paid within
the next fiscal year?
STATE OF WEST VIRGINIA
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - CLAIMS AND JUDGMENTS/CONTINGENCIES
Agency Name: 0 FORM 1
i. Civil action number and location of the court, where applicable.
j. Please indicate office and lawyer handling the case.
k. Attach the supporting documentation used to assess the outcome of the item.
2. JUDGMENTS OR SETTLEMENTS FROM LAST REPORTING PERIOD
Case style
Amount
Explain any judgments rendered or settlements made, if any, from July 1, 2009, through the date
you respond to this form.
For litigation reported on the June 30, 2009, closing book form(s) that is/are not reported on this form,
please describe the action taken for each of these litigation matters
(dismissed, settled, not currently outstanding, etc.).
3. OTHER MATTERS
List material events, other than matters listed in parts 1 or 2, affecting the agency from July 1, 2010,
to the date you return this form.
Has the liability been included in a future budget?
Which year(s)? Amount?
Please sign, date, and return
Prepared By this form along with supporting
documentation to:
Print Name Financial Accounting and Reporting
Building 17, 3rd Floor
2101 Washington Street East
Agency Telephone Number Charleston, WV 25305
Fax Number 304-558-4084
Date FARS contact: Jane Shinn 304-558-4083
Jane's email Jane.A.Shinn@wv.gov
STATE OF WEST VIRGINIA
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - CLAIMS AND JUDGMENTS/CONTINGENCIES
Agency Name: 0 FORM 1
Instructions:
Your responses to this questionnaire should include matters that existed at June 30, 2009 and June 30, 2010. For those claims and
judgments/contingencies reported on the June 30, 2009 closing book form that are no longer outstanding, please skip to question 2.
Please MAKE COPIES AND COMPLETE A SEPARATE QUESTIONNAIRE FOR EVERY
CONTINGENCY meeting the following guidelines:
Liabilities that are reasonably estimated to be equal to or in excess of $1,000,000 or liabilities that are reasonably estimated to be equal to or in
excess of $20,000,000 in the aggregate. The more information your agency can provide the better. If your agency does not have claims worth
$1,000,000 or $20,000,000 in the aggregate, please check N/A on the transmittal form.
The following should be reported on this form:
Pending legal actions
Unresolved audit findings
Possible Federal disallowances
Any other activities that may result in costs to the State directly or indirectly
For all pending legal claims reported, complete all parts of question 1. Note: question 1. H., unfavorable outcome:
REMOTE: indicates the State should prevail and will not owe any money.
REASONABLY POSSIBLE: indicates the State is likely to prevail and may not owe any money.
PROBABLE: indicates the State is unlikely to prevail and will owe money.
STATE OF WEST VIRGINIA FORM 2A
DEPARTMENT OF ADMINISTRATION-FINANCE DIVISION GAAP REPORTING FORM - CASH IN BANK
FINANCIAL ACCOUNTING AND REPORTING SECTION
AGENCY NAME 0
OUTSIDE BANK ACCOUNTS INFORMATION SHEET
A few agencies will require more pages. To download
an expanded multi-page file, click the following link:
http://www.wvfinance.state.wv.us/forms/FARSforms/form2a.xlsx
PLEASE COMPLETE LINES 1-5 REGARDLESS OF MATERIALITY LEVELS.
NOTE: THERE IS A $100,000 RECEIPTS OR A $25,000 ENDING BALANCE MATERIALITY LEVEL FOR EACH BANK ACCOUNT.
1. FINANCIAL INSTITUTION NAME DESCRIPTION (Check One)
2. BANK ACCOUNT NUMBER CHECKING
3. ABA NUMBER SAVINGS
DESCRIPTION (Check One)
TRUST
OPERATING
4. PURPOSE OF ACCOUNT
A B C D
BOOK BALANCE BOOK BALANCE
BEGINNING OF RECEIPTS DISBURSEMENTS END OF
FISCAL YEAR FROM LINE 9 FROM LINE 13 FISCAL YEAR
(A+B-C)
5. TOTAL $0.00
A. LINE 5, COLUMN A SHOULD BE THE SAME AS REPORTED AS JUNE 30 BALANCE IN PREVIOUS YEAR
B. LINE 5, COLUMN D SHOULD EQUAL JUNE 30 BOOK BALANCE FOR CURRENT YEAR ON FORM 2B
REVENUE
RECEIPTS AMOUNT TYPE # DISBURSEMENTS AMOUNT
TABLE BELOW
6. RECEIPTS FROM OUTSIDE SOURCES 10. DISBURSEMENT TO OUTSIDE SOURCES
6a. RECEIPTS FROM OUTSIDE SOURCES 10a. DISBURSEMENT TO OUTSIDE SOURCES
7. RECEIPTS FROM AUDITOR'S OFFICE/WVFIMS 11. DISBURSEMENT TO AUDITOR'S OFFICE/WVFIMS
8. RECEIPTS FROM OTHER BANK ACCOUNTS 12. DISBURSEMENT TO OTHER BANK ACCOUNTS
9. TOTAL RECEIPTS (6+6a+7+8) $0.00 13. TOTAL DISBURSEMENTS (10+10a+11+12) $0.00
*DESCRIPTION OF RECEIPTS & DISBURSEMENTS TO/FROM AUDITOR'S OFFICE AND OUTSIDE SOURCES:
Types of Revenue
4110 Personal Income Tax 4170 Insurance Tax 4220 Charges for Services
4120 Consumer Sales Tax 4180 Gas & Motor Carrier Tax 4230 Investment Revenue
4125 Unemployment Tax 4190 Auto Privilege Tax 4300 Other Revenue (describe)
4130 Severance Tax 4195 Other Taxes (describe) 7020 Interest Income
4140 Corporate Income Tax 4200 Federal Revenue
4150 B & O Tax 4210 Licenses, Fees, Permits
4160 Business Franchise Tax 4215 MV Reg, Lic, & Permit
14. Does your agency have any other outside cash and/or investments not already reported on form 2A?
Yes Please include supporting documentation
No
Please send this form to:
State of West Virginia
PREPARED BY Financial Accounting and Reporting Section
Building 17, 3rd Floor
2101 Washington Street East
AGENCY TELEPHONE NUMBER Charleston, WV 25305
Fax Number 304-558-4084
FARS contact: Jane Shinn 304-558-4083
DATE Jane's e-mail Jane.A.Shinn@wv.gov
STATE OF WEST VIRGINIA FORM 2A
DEPARTMENT OF ADMINISTRATION-FINANCE DIVISION GAAP REPORTING FORM - CASH IN BANK
FINANCIAL ACCOUNTING AND REPORTING SECTION
PURPOSE
To collect data on cash outside of the Treasurer’s Office, for inclusion in the State's annual financial statements. The purpose of this form is to describe each account
and its activity during the fiscal year.
ACCOUNTING POLICY
GAAP requires that assets held by a government be accounted for and reported in the State's annual financial statements.
CASH WITH THE TREASURER’S OFFICE
Agencies/departments are NOT responsible for reporting monies at the Treasurer’s Office.
CASH OUTSIDE THE TREASURER’S OFFICE
The agency must report cash under its direct control, including assets which may represent trust funds, where the agency acts as custodian for a third party.
For bank deposits, disclosures must be made in the footnotes to the financial statements regarding the degree to which they are insured or are constrained by
legal or contractual provisions.
Cash and cash equivalents include petty cash, bank accounts and cash held in highly liquid, short-term investments. Negotiable certificates of deposit should continue being
reported on forms 2a and 2b.
PROCEDURES
A. Cash with State Agencies/Departments - For all bank accounts outside the control of the Treasurer, deposit and withdrawal records should be used to
compute activity for the fiscal year. The amounts of items, which have not cleared the bank through June 30, should also be used.
B. Restricted Cash - Restricted Cash is money that is set aside for a particular purpose. For the accounts described in A, identify those which re present
trust funds. Trust funds are defined as those, which are held for individuals, private organizations, or other governments. For each such account, the
total additions to and withdrawals from the account during the fiscal year should be computed based on the bank statements.
SOURCES OF DATA
1. Bank Statements
2. Deposit and withdrawal records at institution
For each material bank account OUTSIDE the control of the Treasurer in which funds were held during the fiscal year, complete Form 2A and Form 2B. FARS has placed a
materiality limit per bank account. If the true receipts are over $100,000 or the ending balance is $25,000 or greater, you must complete these forms. If the bank
account does not meet these criteria complete lines 1 through 5 and write N/A on the transmittal.
STATE OF WEST VIRGINIA FORM 2A
DEPARTMENT OF ADMINISTRATION-FINANCE DIVISION GAAP REPORTING FORM - CASH IN BANK
FINANCIAL ACCOUNTING AND REPORTING SECTION
INSTRUCTIONS
The following information should be provided:
LINE 1. Name of the Financial Institution
LINE 2. Bank Account Number AND Define whether account is checking or savings account
LINE 3. ABA number. This is the bank's identification number (routing number) and can be obtained from the bank or financial institution and define whether account is
an operating or a trust account
LINE 4. Give a "Brief" description of the purpose of the account
LINE 5.
A. Show the BOOK balance of the account as of July 1, 2009, in Column A. The amount should be the same amount reported as the ending balance as
of June 30, 2010, in the previous year Closing Book.
B. Show the amount of total receipts for the fiscal year (Column B). This amount should equal the amount shown on line 9.
C. Show amount of disbursements for the fiscal year (Column C). This amount should equal the amount shown on line 13.
D. Calculate the BOOK balance of account as of June 30, 2010 in Column D (A plus B minus C).
LINE 6. Show the portion of receipts that came from outside sources such as other agencies. Also, show the appropriate revenue type using the table on the form.
Identify the revenue types by number.
LINE 7. Show the portion of receipts that came from the Auditor’s Office. Show the appropriate revenue type using the table on the form.
LINE 8. Show the portion of receipts that came from other bank accounts. If transfers between accounts occur they need to be report ed. Show the appropriate revenue
type using the table on the form.
LINE 9. Calculate the total receipts as of June 30, 2009, (line 6 plus line 7 plus line 8).
LINE 10. Show the portion of disbursements that were transferred to outside sources.
LINE 11. Show the portion of disbursements that were transferred to the Auditor’s Office.
LINE 12. Show the portion of disbursements that were transferred between bank accounts.
LINE 13. Calculate total disbursements as of June 30, 2008, (line 10 plus line 11 plus line 12)
LINE 14. Select Yes or No - - Does your agency have other outside cash and/or investments not already reported on forms 2A and 2B?
STATE OF WEST VIRGINIA
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION FORM 2B
GAAP REPORTING FORM - CASH IN BANK
A few agencies will require more pages. To download
Agency Name 0 an expanded multi-page file, click the following link:
http://www.wvfinance.state.wv.us/forms/FARSforms/form2b.xlsx
Bank Account Number
OUTSIDE BANK ACCOUNTS
BANK RECONCILIATION
For each bank account NOT DEPOSITED WITH THE TREASURER,
perform a reconciliation for each account using the form below and attach a copy of the
June 30, 2010 bank statement, list of any outstanding checks and outstanding deposits.
Provide in an electronic file the outstanding items in the following format: 1) date check was written, 2) check number, 3) payee, 4) check amount, and 5) federal fund percentage.
AMOUNT
1. Balance Per Bank Statement at June 30
2. Add: Deposits In Transit (attach list of deposits)
3. Subtract: Outstanding Checks (attach list of checks)
4. Other Adjustments (attach itemized list)
5. Reconciled Book Balance at June 30
(Same as Line 5, Column D, on Outside Bank Account, Form 2A) $0.00
Please send this form along with detail to: ****NEW for FY 2010****
PREPARED BY This year the West Virginia State Treasurer's Office is
State of West Virginia asking all agencies to submit their end-of-year outside
Financial Accounting and Reporting Section bank information on their new web base program. To
Building 17, 3rd Floor access program log on to
AGENCY TELEPHONE NUMBER 2101 Washington Street East and http://apps.wvsto.com/outsidebankaccounts
Charleston WV, 25305
Instructions are included for this process once you are
Fax Number 304-558-4084 logged in. If you are a new program user or do not
DATE FARS contact: Jane Shinn 304-558-4083 have a user id contact Julie Hefner-Ferrell with the
e-mail Jane.A.Shinn@wv.gov Treasurer's Office.
Phone: 304-340-2718
email: julie.hefner-ferrell@wvsto.com
STATE OF WEST VIRGINIA
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION FORM 2B
PURPOSE
To collect data on cash outside of the Treasurer’s Office, for inclusion in the State's annual financial statements.
ACCOUNTING POLICY
GAAP requires that assets held by a government be accounted for and reported in the State's annual financial statements.
CASH WITH THE TREASURER’S OFFICE
Agencies/departments are NOT responsible for reporting monies at the Treasurer’s Office.
CASH OUTSIDE THE TREASURER’S OFFICE
The agency must report cash under its direct control, including assets which may represent trust funds, where the agency acts as custodian for a
third party.
For bank deposits, disclosures must be made in the footnotes to the financial statements regarding the degree to which they are insured or are
constrained by legal or contractual provisions.
Cash and cash equivalents include petty cash, bank accounts and cash held in highly liquid, short -term investments. Negotiable certificates of deposit
should continue being reported on forms 2a and 2b.
INSTRUCTIONS
Reconcile the BANK BALANCES to BOOK BALANCE for each account.
LINE1. Record the bank balance per statement at June 30, 2010, on Form 2B.
LINE 2. Record the total deposits in transit on Form 2B and attach a list of the deposits.
LINE 3. Record the total outstanding checks on Form 2B and attach a list of the checks.
(Only include outstanding checks for FY 2010)
LINE 4. Record other adjustments required to balance the
Reconciliation and attach an itemized list.
LINE 5. Record the book balance as of June 30, 2010.
*** ATTACH A COPY OF THE June 30, 2010, BANK STATEMENT FOR EACH ACCOUNT. Include a list of any outstanding checks and
outstanding deposits. The list of outstanding checks should include
1) date check was written
2) check number
3) payee
4) check amount
5) federal fund percentage.
(If the statement date is prior to June 30, please specify if there was any activity between the statement date and June 30.)
STATE OF WEST VIRGINIA FORM 3
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - MATERIAL AND SUPPLIES INVENTORY
This form has ten pages numbered 3-1 thru 3-10.
A few agencies will require more pages. To download
Agency Name: 0 an expanded multi-page file, click the following link:
http://www.wvfinance.state.wv.us/forms/FARSforms/form3.xlsx
PHYSICAL INVENTORY ACCUMULATION FORM
NOTE: THIS FORM HAS A $25,000 MATERIALITY LEVEL
PER LOCATION (e.g. per State Hospital)
1 2 3 4 5
Description Quantity Unit Cost Unit of Total Cost
Measure (Column 2 X Column 3)
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
6. VALUATION METHOD (FIFO, LIFO, Average Cost) TOTAL: $ -
Please mail backup support to:
Prepared By
State of West Virginia
Financial Accounting Reporting Section
Agency Telephone Number Building 17, 3rd Floor
2101 Washington Street East
Charleston, WV 25305
Date Fax Number 304-558-4084
FARS contact: Angela Leshon 304-558-4083
Angela's email is Angela.D.Leshon@wv.gov
Tab 3-1
STATE OF WEST VIRGINIA FORM 3
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - MATERIAL AND SUPPLIES INVENTORY
PURPOSE
To accumulate the value of material and supplies inventory (exclusive of Fixed Assets, which are addressed on a separate Closing
Form,) on hand at June 30, based on a physical inventory count.
ACCOUNTING POLICY
Inventories are defined as the amount of goods on hand which may be held for internal consumption or for resale to other units of state
government or outside parties. Although materials and supplies are recorded by the State as expenditures at the time of purchase, the
unused balance on hand at year-end must be included in the State's financial reports.
In order to accumulate this information, a physical count of items on hand must be performed, using the periodic or perpetual inventory
method. If using the periodic inventory system, the physical inventory should be taken at June 30, or, if using the perpetual system, it may be
taken on a cyclical basis (i.e. a portion of the materials and supplies may be counted and verified periodically during the year).
PROCEDURES
1. Count: These inventories should ordinarily be maintained in a central storage area where they can be counted quickly. If the
agency/department estimates its inventory has a value greater than $25,000 per location (e.g. per State Hospital), it should conduct a physical
inventory on the last working day before June 30. If you regularly perform a physical count on a different time interval, please provide a roll-
forward of activity from the date of your last physical count to June 30.
2. Valuation: Agencies/departments who are not on another valuation method should use the first-in, first-out (FIFO) valuation method to
report physical inventories (see #6 under instructions). Once the physical count is performed, invoices and other documentation must be used
to compute the value of the inventory. Physical inventories should be summarized into general classifications using the attached form.
If you have any questions or problems performing a physical inventory count, please contact FARS (304-558-4083).
SOURCES OF DATA
1. Invoices (this invoice needs to be the last invoice received for the particular item prior to June 30.
2. Physical count
INSTRUCTIONS
Use the Physical Inventory Accumulation Form to record your physical count. If your agency maintains a computerized inventory listing
containing a description of each inventory item, quantity on hand, individual cost for each item, and grand total, then the physical inventory
accumulation form only needs to be submitted with a grand total and a copy of your inventory listing. This is for your total Inventory at June
30.
FARS has placed a $25,000 materiality limit on inventory per location. If you do not have $25,000 worth of inventory at June 30,
please check N/A on the transmittal form.
The balance on hand at year end will include those goods which are in transit and are FOB shipping point - meaning title passes to the
purchaser once goods are placed on the carrier from the point of origin. If you have goods in transit which are FOB shipping point, be sure to
include these in your count. Include in Column:
1. A description of each inventory item on hand at June 30 (DO NOT INCLUDE FIXED ASSETS). As you begin to count each item,
record it by name and brief description (if not obvious).
2. The quantity of inventory items. Enter your inventory count here (please use decimals not fractions).
3. This column is for individual cost of each item. Determine the unit cost for each item from the invoice or other relevant source.
4. This column is for the unit of measure. A listing of valid codes is included after the instructions for this form.
5. The total of Column 2 multiplied by Column 3 will yield the value of the inventory items on hand at June 30. If it is obvious that
your agency does not have $25,000 worth of inventory, please check N/A on the transmittal form.
6. Valuation Method
Tab 3-1
STATE OF WEST VIRGINIA FORM 3
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
Valuation - MATERIAL AND SUPPLIES INVENTORY
GAAP REPORTING FORMMethod
6.
Enter the cost method used to value the inventory in the box located at the bottom of the form. Use first-in, first-out (FIFO) if no method was
previously adopted.
Valuation Methods
FIFO - (first-in, first-out) the goods purchased first are the goods used first; therefore ending inventory consists of items most recently
purchased.
LIFO - (last-in, first-out) the goods purchased most recently are the goods used first; therefore, ending inventory consists of items
purchased first.
Average Cost - the total dollar amount of inventory is divided by the number of goods for an average cost per item.
7. UNITS OF MEASURE
UNITS
OF
MEASURE DESCRIPTION
AC Acre
BD Bundle
BG Bag
BL Barrel
BT Bottle
BU Bushel
BX Box
C Cycle
CCF Price per Hundred Cubic Feet
CF Cubic Feet
CI Cubic Inch
CN Can
CS Case
CT Carton
CU Cube
CW Hundred Weight (per Hundred Weight
(Paper, Steel, etc.))
CY Cubic Yard (27 cubic feet)
DG Diluted Gallons
DOS Dose
DR Drum
DZ Dozen
EA Each
FT Foot
GL Gallon (4 Quarts)
GM Gram
IN Inch
KG Kilogram (1000 Grams)
KT Kit
LB Pound (16 ounces)
LF Lineal Foot
LNE Line
LS Lump Sum
LT Liter (.2462 US Gallon)
MCF MCFT (Price per Thousand Feet (Fuel))
ML Milliliter (0.0338 US Fluid Ounces)
MT Metric Ton
OZ Ounce
PC Per Hundred
PG Page
PM Per Thousand
PR Pair
PT Pint (16 Fluid Ounces)
QR Quire (24 Sheets)
QT Quart (2 Pints)
RD Rod (5 ½ Yards)
RL Roll
RM Ream (20 Quires)
SF Square Foot (144 Square Inches)
SH Sheet
SI Square Inch (.007 Square Foot)
SM Square Mile (640 Acres)
SR Square Rod (30 1/4 Yards)
ST Set
SY Square Yard (9 Square Feet)
TB Tube
TN Ton
U Unit
VIL Vial
Tab 3-1
STATE OF WEST VIRGINIA FORM 3
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
VIL Vial
GAAP REPORTING FORM - MATERIAL AND SUPPLIES INVENTORY
Tab 3-1
STATE OF WEST VIRGINIA FORM 3
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - MATERIAL AND SUPPLIES INVENTORY
Agency Name: 0
PHYSICAL INVENTORY ACCUMULATION FORM
NOTE: THIS FORM HAS A $25,000 MATERIALITY LEVEL
PER LOCATION (e.g. per State Hospital)
1 2 3 4 5
Description Quantity Unit Cost Unit of Total Cost
Measure (Column 2 X Column 3)
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
6. VALUATION METHOD (FIFO, LIFO, Average Cost) TOTAL: $ -
Total from 3-1 plus current total $ -
Please mail backup support to:
Prepared By
State of West Virginia
Financial Accounting Reporting Section
Agency Telephone Number Building 17, 3rd Floor
2101 Washington Street East
Charleston, WV 25305
Date Fax Number 304-558-4084
FARS contact: Angela Leshon 304-558-4083
Angela's email is Angela.D.Leshon@wv.gov
Tab 3-2
STATE OF WEST VIRGINIA FORM 3
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - MATERIAL AND SUPPLIES INVENTORY
Agency Name: 0
PHYSICAL INVENTORY ACCUMULATION FORM
NOTE: THIS FORM HAS A $25,000 MATERIALITY LEVEL
PER LOCATION (e.g. per State Hospital)
1 2 3 4 5
Description Quantity Unit Cost Unit of Total Cost
Measure (Column 2 X Column 3)
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
6. VALUATION METHOD (FIFO, LIFO, Average Cost) TOTAL: $ -
Total from 3-2 plus current total $ -
Please mail backup support to:
Prepared By
State of West Virginia
Financial Accounting Reporting Section
Agency Telephone Number Building 17, 3rd Floor
2101 Washington Street East
Charleston, WV 25305
Date Fax Number 304-558-4084
FARS contact: Angela Leshon 304-558-4083
Angela's email is Angela.D.Leshon@wv.gov
Tab 3-3
STATE OF WEST VIRGINIA FORM 3
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - MATERIAL AND SUPPLIES INVENTORY
Agency Name: 0
PHYSICAL INVENTORY ACCUMULATION FORM
NOTE: THIS FORM HAS A $25,000 MATERIALITY LEVEL
PER LOCATION (e.g. per State Hospital)
1 2 3 4 5
Description Quantity Unit Cost Unit of Total Cost
Measure (Column 2 X Column 3)
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
6. VALUATION METHOD (FIFO, LIFO, Average Cost) TOTAL: $ -
Total from 3-3 plus current total $ -
Please mail backup support to:
Prepared By
State of West Virginia
Financial Accounting Reporting Section
Agency Telephone Number Building 17, 3rd Floor
2101 Washington Street East
Charleston, WV 25305
Date Fax Number 304-558-4084
FARS contact: Angela Leshon 304-558-4083
Angela's email is Angela.D.Leshon@wv.gov
Tab 3-4
STATE OF WEST VIRGINIA FORM 3
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - MATERIAL AND SUPPLIES INVENTORY
Agency Name: 0
PHYSICAL INVENTORY ACCUMULATION FORM
NOTE: THIS FORM HAS A $25,000 MATERIALITY LEVEL
PER LOCATION (e.g. per State Hospital)
1 2 3 4 5
Description Quantity Unit Cost Unit of Total Cost
Measure (Column 2 X Column 3)
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
6. VALUATION METHOD (FIFO, LIFO, Average Cost) TOTAL: $ -
Total from 3-4 plus current total $ -
Please mail backup support to:
Prepared By
State of West Virginia
Financial Accounting Reporting Section
Agency Telephone Number Building 17, 3rd Floor
2101 Washington Street East
Charleston, WV 25305
Date Fax Number 304-558-4084
FARS contact: Angela Leshon 304-558-4083
Angela's email is Angela.D.Leshon@wv.gov
Tab 3-5
STATE OF WEST VIRGINIA FORM 3
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - MATERIAL AND SUPPLIES INVENTORY
Agency Name: 0
PHYSICAL INVENTORY ACCUMULATION FORM
NOTE: THIS FORM HAS A $25,000 MATERIALITY LEVEL
PER LOCATION (e.g. per State Hospital)
1 2 3 4 5
Description Quantity Unit Cost Unit of Total Cost
Measure (Column 2 X Column 3)
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
6. VALUATION METHOD (FIFO, LIFO, Average Cost) TOTAL: $ -
Total from 3-5 plus current total $ -
Please mail backup support to:
Prepared By
State of West Virginia
Financial Accounting Reporting Section
Agency Telephone Number Building 17, 3rd Floor
2101 Washington Street East
Charleston, WV 25305
Date Fax Number 304-558-4084
FARS contact: Angela Leshon 304-558-4083
Angela's email is Angela.D.Leshon@wv.gov
Tab 3-6
STATE OF WEST VIRGINIA FORM 3
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - MATERIAL AND SUPPLIES INVENTORY
Agency Name: 0
PHYSICAL INVENTORY ACCUMULATION FORM
NOTE: THIS FORM HAS A $25,000 MATERIALITY LEVEL
PER LOCATION (e.g. per State Hospital)
1 2 3 4 5
Description Quantity Unit Cost Unit of Total Cost
Measure (Column 2 X Column 3)
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
6. VALUATION METHOD (FIFO, LIFO, Average Cost) TOTAL: $ -
Total from 3-6 plus current total $ -
Please mail backup support to:
Prepared By
State of West Virginia
Financial Accounting Reporting Section
Agency Telephone Number Building 17, 3rd Floor
2101 Washington Street East
Charleston, WV 25305
Date Fax Number 304-558-4084
FARS contact: Angela Leshon 304-558-4083
Angela's email is Angela.D.Leshon@wv.gov
Tab 3-7
STATE OF WEST VIRGINIA FORM 3
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - MATERIAL AND SUPPLIES INVENTORY
Agency Name: 0
PHYSICAL INVENTORY ACCUMULATION FORM
NOTE: THIS FORM HAS A $25,000 MATERIALITY LEVEL
PER LOCATION (e.g. per State Hospital)
1 2 3 4 5
Description Quantity Unit Cost Unit of Total Cost
Measure (Column 2 X Column 3)
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
6. VALUATION METHOD (FIFO, LIFO, Average Cost) TOTAL: $ -
Total from 3-7 plus current total $ -
Please mail backup support to:
Prepared By
State of West Virginia
Financial Accounting Reporting Section
Agency Telephone Number Building 17, 3rd Floor
2101 Washington Street East
Charleston, WV 25305
Date Fax Number 304-558-4084
FARS contact: Angela Leshon 304-558-4083
Angela's email is Angela.D.Leshon@wv.gov
Tab 3-8
STATE OF WEST VIRGINIA FORM 3
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - MATERIAL AND SUPPLIES INVENTORY
Agency Name: 0
PHYSICAL INVENTORY ACCUMULATION FORM
NOTE: THIS FORM HAS A $25,000 MATERIALITY LEVEL
PER LOCATION (e.g. per State Hospital)
1 2 3 4 5
Description Quantity Unit Cost Unit of Total Cost
Measure (Column 2 X Column 3)
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
6. VALUATION METHOD (FIFO, LIFO, Average Cost) TOTAL: $ -
Total from 3-8 plus current total $ -
Please mail backup support to:
Prepared By
State of West Virginia
Financial Accounting Reporting Section
Agency Telephone Number Building 17, 3rd Floor
2101 Washington Street East
Charleston, WV 25305
Date Fax Number 304-558-4084
FARS contact: Angela Leshon 304-558-4083
Angela's email is Angela.D.Leshon@wv.gov
Tab 3-9
STATE OF WEST VIRGINIA FORM 3
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - MATERIAL AND SUPPLIES INVENTORY
This form has ten pages numbered 3-1 thru 3-10.
Agency Name: 0 A few agencies will require more pages. To download
an expanded multi-page file, click the following link:
PHYSICAL INVENTORY ACCUMULATION FORM http://www.wvfinance.state.wv.us/forms/FARSforms/form3.xls
(this will take several minutes)
NOTE: THIS FORM HAS A $25,000 MATERIALITY LEVEL
PER LOCATION (e.g. per State Hospital)
1 2 3 4 5
Description Quantity Unit Cost Unit of Total Cost
Measure (Column 2 X Column 3)
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
6. VALUATION METHOD (FIFO, LIFO, Average Cost) TOTAL: $ -
Total from 3-9 plus current total $ -
Please mail backup support to:
Prepared By
State of West Virginia
Financial Accounting Reporting Section
Agency Telephone Number Building 17, 3rd Floor
2101 Washington Street East
Charleston, WV 25305
Date Fax Number 304-558-4084
FARS contact: Angela Leshon 304-558-4083
Angela's email is Angela.D.Leshon@wv.gov
3-10
FORM 4A
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - ACCOUNTS RECEIVABLE
Agency Name: 0
INFORMATION SHEET
The revenue has $25,000 materiality level.
1 2 3 4 5
Gross Sales/ Gross
Type of Revenue/ Receivable FY 2010 Receivable Receivable
Reimbursement Receivable June 30, 2009 Sales/Service Collected In FY 2010 June 30, 2010
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
TOTAL: $0 $0 $0 $0
6 7 8 9 10 11 12 13 14
Gross Amount expected Amounts expected to
Type of Revenue/ Receivable Current to be collected be collected after FY Estimated
Reimbursement Receivable June 30, 2010 0-30 days 30-60 days 60-90 days Over 90 days in FY 2011 2011 (Deferred Revenue) Uncollectible
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
TOTAL: $0 $0 $0 $0 $0 $0 $0 $0
Please send this form to:
PREPARED BY
State of West Virginia
Financial Accounting Reporting Section
AGENCY TELEPHONE NUMBER Building 17, 3rd Floor
2101 Washington Street East
Charleston, WV 25305
DATE Fax Number 304-558-4084
FARS contact: Angela Leshon 304-558-4083
Angela's email: Angela.D.Leshon@wv.gov
PURPOSE
To collect data on accounts receivable from individuals or private organizations (exclusive of receivables from Federal or Local Governmental units, State Agencies or Loans Receivable, which
are all addressed in other closing book sections).
ACCOUNTING POLICY
GAAP requires that assets held by a government be accounted for and reported in the State's annual financial statements. Revenue is recognized based on the type of fund used to record account
transactions. The modified accrual basis of accounting is used in governmental fund types, while the accrual basis is used for proprietary fund types. In addition, revenues are recognized for restricted
grants based on related expenditures.
On the modified accrual basis, revenues are recognized in the accounting period in which they become susceptible to accrual. This means that the underlying event has taken place and that the
government has an enforceable legal claim to the amount. An example of an amount receivable for which this section applies would be the hospital expenses billed to an individual for outpatient care.
The State's policy is to recognize modified accrual basis revenue related to accounts receivable in the current accounting period. GAAP requires that an appropriate provision for uncollectible accounts
be established. If all legal efforts to collect the account have failed, and collection is not expected to occur, an allowance for uncollectible accounts must be determined by your agency.
PROCEDURES
Each agency maintains its own records regarding Accounts receivable with private individuals and organizations. First, the uncollected amounts due to the State as of June 30 must be identified.
Second, the collectability of those accounts must be assessed by the agency. Amounts deemed uncollectible are those with a high likelihood that payment will not occur.
INSTRUCTIONS
Complete the attached form for total accounts receivable or if your agency has court settlement revenue (restitution), otherwise please check N/A on the transmittal form.
Please complete Columns 1 through 14 of the attached Information Sheet as indicated by the various headings. Please include in Column:
List the type of receivable: (ex. Fishing license, magazine sales, cabin rental, etc.)
Record the beginning gross receivable balance for the fiscal year. For FY 2010, this column list the gross receivables reported on 6/30/09, which should agree to the prior year ending balance. If
not, please provide an explanation.
Record all sales / services for the receivable type for FY 2010. If this information is not available, please provide an explanation.
Record the amount of sales / services collected in FY 2010 by receivable type. If this information is not available, please provide an explanation.
Record the gross receivable as of 6/30/10 by type. Column 5 should equal columns (2 plus 3 minus 4).
List the type of receivable used in Column 1. If the receivable relates to a prior year, include the year of the receivable in front of the type (ex. 6/30/09 Magazine Sales; 06/30/09 Cabin Rental).
Record the gross receivable as of 6/30/10, as recorded in column 5.
Record the amount of gross receivables that are 0-30 days past due.
Record the amount of gross receivables that are 30-60 days past due.
Record the amount of gross receivables that are 60-90 days past due.
Record the amount of gross receivables that are over 90 days past due.
Current Receivable: Record the amount of gross receivable that your agency expects to collect in the next fiscal year (i.e. FY 2011). (Healthcare Facilities – record the amount that you expect to
collect after removing contractual write-downs.)
Deferred Revenue: Record the amount of gross receivable that your agency expects to collect after FY 2009 (i.e. FY 2011 and beyond). Receivables that are not collected within one year are
considered deferred revenue.
STATE OF WEST VIRGINIA FORM 4B
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - INTRA-AGENCY RECEIVABLES
Agency Name: 0
DUE FROM OTHER FUNDS Indicate amounts due from OTHER AGENCIES* as of June 30, 2010
1 2 3 4 5
(Indicate by
State-Level Org #) Net Receivables
You Do Not
Receivable Gross Allowance for Net Expect to Collect
From Receivables Doubtful Accounts Receivables Within One Year
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
Total $0 $0 $0 $0
6. Explain amounts due from other agencies greater than or equal to $1,000,000
*Other agencies are defined as all entities which are NOT component units (see Form 4C for a list).
*Please copy this form or attach additional pages as necessary
Please send this form to:
PREPARED BY
State of West Virginia
Financial Accounting Reporting Section
AGENCY TELEPHONE NUMBER Building 17, 3rd Floor
2101 Washington Street East
Charleston, WV 25305
DATE Fax Number 304-558-4084
FARS contact: Angela Leshon 304-558-4083
Angela's email is Angela.D.Leshon@wv.gov
STATE OF WEST VIRGINIA FORM 4B
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - INTRA-AGENCY RECEIVABLES
Intergovernmental Transactions Receivable - From Other Agencies and Component Units.
PURPOSE
To identify amounts due from State agencies/departments for reporting purposes at June 30.
ACCOUNTING POLICY
State agency, which provides goods and services to other state agencies, is listed here. GAAP requires that
amounts owed at June 30 from state agencies be recorded as either Due From Other Funds -Primary
Government or Due From Other Funds - Component Units.
PROCEDURES
Identify all amounts owed to your agency (those transactions for which your agency provided something of
value to another agency before June 30, but had not received payment as of that date). Since a distinction
must be made between other agencies and component units, there are two separate information sheets. FORM
4B - Amounts due from other agencies, and FORM 4C - Amounts due from Component Units. A list of
component units has been provided at the bottom of FORM 4C. Please indicate, by number, the component unit
that received the services.
Include in Column:
1) Agency Name (State-level Org #) or (Component Unit #) that received the services.
2) Record amounts greater than or equal to $10,000 per agency (line) of gross receivables that are
currently due.
3) Record the amount of the receivable that your agency deems uncollectible. An amount estimated
to be uncollectible must be given. If your agency estimates that the entire receivable will be collected,
then indicate $0 in the space provided.
4) Record the net amount of receivables that are currently due.
5) Record the amount of net receivables that your agency does not expect to collect within the next year.
Include in Line 6 any net receivables that are greater than or equal to $1,000,000.
STATE OF WEST VIRGINIA FORM 4C
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - INTRA-AGENCY RECEIVABLES
Agency Name: 0
DUE FROM Indicate amounts due from COMPONENT UNITS as of June 30, 2010
COMPONENT
UNITS
1 2 3 4 5
Net Receivables
(indicate by #) You Do Not
Receivable Gross Allowance for Net Expect to Collect
From Receivables Doubtful Accounts Receivables Within One Year
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
Total $0 $0 $0 $0
Explain amounts due from other agencies greater than or equal to $1,000,000.
COMPONENT UNITS
1. Water Development Authority 8. Parkways & Economic Development, and Tourism Authority
2. Solid Waste Management Board 9. Regional Jail Authority
3. Educational Broadcasting Authority 10. Racing Commission
4. WV State Rail Authority 11. Public Defenders Corporation
5. Economic Development Authority 12. Higher Education Fund
6. Jobs Investment Trust 13. School Building Authority
7. Housing Development Fund
Please send this form to:
Prepared By
State of West Virginia
Financial Accounting Reporting Section
Agency Telephone Number Building 17, 3rd Floor
2101 Washington Street East
Charleston, WV 25305
Date Fax Number 304-558-4084
FARS contact: Angela Leshon 304-558-4083
Angela's email is Angela.D.Leshon@wv.gov
INSTRUCTIONS
Complete the Due From Information Sheets as appropriate based on the definition from the previous
page; FORM 4B for other agency due from, and FORM 4C for component unit due from.
If the agency does not have receivables from other agencies, check N/A on the transmittal.
Include in Column:
1) Agency Name (State-level Org #) or (Component Unit #) that received the services.
2) Record amounts greater than or equal to $10,000 per agency (line) of gross receivables that
are currently due.
3) Record the amount of the receivable that your agency deems uncollectible. An amount
estimated to be uncollectible must be given. If your agency estimates that the entire
receivable will be collected, then indicate $0 in the space provided.
4) Record the net amount of receivables that are currently due.
5) Record the amount of net receivables that your agency does not expect to collect within the
next year.
Include in Line 6 any net receivables that are greater than or equal to $1,000,000.
GOVERNMENTAL FUNDS
Org ID Org ID
Legislative Environmental Protection
2100 Senate 0311 Environmental Quality Board
2200 House of Delegates 0313 Environmental Protection, Dept of
2300 Legislative Services 0315 Oil & Gas Conservation Commission
0325 Air Quality Board
Judicial Health and Human Resources
2400 Supreme Court 0501 Health and Human Resources, Dept of
0503 Women's Commission
Executive 0506 Division of Health
0100 Governor's Office 0507 Health Care Authority
1200 Auditor's Office 0510 Human Rights Commission
1300 Treasurer's Office 0511 Division of Human Services
1301 Treasurer - Stop Payment Section
1302 Treasurer - Unclaimed Property
1400 Agriculture
1500 Attorney General
1600 Secretary of State
1601 Elections Commission
Administration Military Affairs and Public Safety
0201 Secretary of Administration 0601 Military Affairs & Public Safety, Dept of
0209 Finance, Division of 0603 Adjutant General
0213 Purchasing, Division Of 0604 Armory Board
0214 Surplus Property 0605 Parole Board
0217 Commission on Uniform State Laws 0606 Homeland Security and Emergency Management
0219 Public Employee's Grievance Board 0608 Corrections, Division Of
0220 Ethics Commission 0612 State Police
0221 Public Defenders 0613 Veterans Affairs
0222 Personnel, Division of 0618 Veterans Home
0224 Commodities & Services from the handicapped 0619 Fire Commission
0228 Prosecuting Attorneys Institute 0620 Criminal Justice Services
0230 Children's Health Insurance Agency (CHIP) 0621 Juvenile Services
0233 Real Estate Division 0622 Protective Services, Division of
Education Revenue
0402 Education, Department Of 0303 Banking, Division Of
0403 Schools for the Deaf & the Blind 0701 Secretary of Revenue
0431 WV Department of Education and the Arts 0702 Tax Division
0432 Culture & History, Division Of 0704 Insurance Commission
0433 Library Commission 0703 Budget Section
0932 Rehabilitation Services 0709 Office of Tax Appeal
----- Center for Professional Development 0706 Municipal Bond Commission
Senior Services
0508 Bureau of Senior Services
Commerce Transportation
0304 Tourism, WV Development Office 0800 Transportation, Dept of
0305 Forestry, WV Division of 0802 Motor Vehicles, Division Of
0306 Geological & Economic Survey 0803 Highways, Division Of
0307 WV Development Office 0804 State Rail Authority
0308 Labor, WV Division of 0805 Public Transit
0310 Natural Resources, WV Division of 0806 Public Port Authority
0314 Miners Health Safety & Training, Office of 0807 Aeronautics Commission
0319 Coal Mine Health & Safety
0320 Coal Mine Safety & Technical Review
0323 WORKFORCE West Virginia
0327 Secretary of Commerce
0328 Division of Energy
0331 Governor's Workforce Investment Office
Agency Listing
Org ID Org ID
MISC. BOARDS AND COMMISSIONS
0900 Independent Agencies 0923 Veterinary Medicine, Board of
0901 Appraiser Licensing Certification Board 0924 Cable Television Advisory Board
0902 Funeral Service Examiners, Board of 0925 Farm Management Commission
0903 Surveyors, Board of Professional 0926 Public Service Commission (PSC)
0904 Counseling, Board of Examiners In 0927 WV Real Estate Commission
0905 Social Work Examiners, Board of 0929 Foresters, Board of
0906 Licensed Practical Nurses, Board of 0930 Speech-Language Pathology Audiology, Board of Examiners
0907 Registered Nurses, Board of 0931 Advisory Council on Vocational Education
0908 Chiropractic Examiners, Board of 0933 Athletic Commission
0909 Dental Examiners, Board of 0935 Respiratory Care, Board of
0910 Landscape Architects, Board of 0936 Dietitians, Board of Licensed
0911 Occupational Therapy, Board of 0937 Acupuncture, Board of
0912 Optometry, Board of 0938 Massage Therapists Board
0913 Pharmacy, Board of 0939 WV Courthouse Facilities Improvement Authority
0914 Psychologists Board of Examiners 0940 WV Statewide Addressing and Mapping Board
0915 Medical Imaging & Radiation Therapy Tech BOE 0941 National Coal Heritage Area Authority & Bd
0916 Sanitarians, Board of 0942 Coal Heritage Highway Authority & Board
0917 Engineers, Board of Professional 0943 WV Center For Nursing
0918 Accountancy, Board of 0945 Medicine, Board of
0919 Architects, Board of 0505 Barbers & Cosmetologists
0921 Osteopathy, Board of 0509 Hospital Finance Authority
0922 Physical Therapy, Board of ----- Humanities Council
ENTERPRISE FUNDS
7892 Access WV 0218 Risk & Insurance Management Board Of
0708 Alcohol Beverage Control Administration ----- Unemployment Compensation
----- Drinking Water Treatment Revolving Fund ----- Water Pollution Control Revolving Fund
0705 Lottery Commission ----- Workers' Compensation Fund (Insurance Commission)
0225 Public Employees Insurance Agency ----- WV Prepaid College Plan
INTERNAL SERVICE FUNDS
0210 Information Services and Communications
0211 Building Commission
0215 Travel Management
0920 Investment Management Board
0950 Treasury Investments, Board of
FIDUCIARY FUNDS
0202 WV Consolidated Public Retirement Board
0204 Teachers Retirement Board (TRS)
0205 Public Employees Retirement System (PERS)
0206 Judges Retirement Board (JRS)
0207 The WV State Police Death, Disability and Retirement Fund (Plan A)
0207 The WV State Police Retirement System (Plan B)
0208 Teachers Defined Contribution Plan (TDC)
0229 Deputy Sheriffs' Retirement System (DSRS)
0234 Emergency Medical Services Retirement System (EMSRS)
0235 Municipal Police Officers and Firefighters Retirement (MPFRS)
0232 WV Retiree Health Benefits Trust Fund (OPEB)
----- Smart 529
Agency Listing
STATE OF WEST VIRGINIA FORM 5
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - OTHER ASSETS
Agency Name: 0
Do you have any of the following ASSETS? NOTE: THIS FORM SHOULD BE COMPLETED
FOR ALL LINES WHICH INDIVIDUALLY
EXCEED $25,000.
Other Assets Categories Amount
Accrued Interest Receivable
Loans, Mortgages, or Notes Receivable
Allowance for Uncollectible (A) (Enter as a negative #)
Postage meter
TOTAL $0
PLEASE PROVIDE SUPPORTING DOCUMENTATION FOR ALL AMOUNTS LISTED ABOVE.
(A): If your agency has LOANS, MORTGAGES, or NOTES RECEIVABLE, please provide an analysis of the
Allowance for Uncollectible accounts, including a discussion of the methods used to determine the size
of the allowance.
Please return completed forms to :
Prepared by
State of West Virginia
Financial Accounting Reporting Section
Agency Telephone Number Building 17, 3rd Floor
2101 Washington Street East
Charleston, WV 25305
Date Fax Number 304-558-4084
FARS contact: Jeff Perkins 304-558-4083
Jeff's email address is Jeff.S.Perkins@wv.gov
STATE OF WEST VIRGINIA FORM 5
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - OTHER ASSETS
PURPOSE:
To collect data required for reporting and disclosure of all other assets not addressed in other closing
forms, which must be included in the State's annual financial statements.
ACCOUNTING POLICY:
GAAP requires that the assets of a government be accounted for and reported in the State's annual
financial statements. Agencies should complete the attached forms for all lines on the forms, which
exceed $25,000 individually.
PROCEDURE:
For all assets other than those identified in the other sections of the closing package, please complete the
attached forms. Definitions are included in order to help you identify transactions or accounts that may fall
within this closing book section. Please attach supporting documentation to the closing book form.
DEFINITIONS FOR OTHER ASSETS ARE AS FOLLOWS:
1. Accrued Interest Receivable. An asset reflecting interest income that has been earned before
June 30, but that is not collected until after June 30.
2. Loans Receivable. An asset reflecting amounts loaned to individuals or organizations external
to a government.
3. Mortgages Receivable. An asset representing the financing of the sale of real property that is
repaid over an extended period, usually in equal installments.
4. Notes Receivable. An asset representing the legal right to receive payment of a certain sum of
money on demand or at a fixed or determinable time, based on an unconditional written
promise signed by the maker.
5. Allowance for Uncollectible. A contra asset representing an estimate of the loan, mortgage and
notes receivable amount that will prove uncollectible.
6. Postage Meter. An asset representing the amount of unused postage credited to postage
meter on June 30.
7. Discount on Bonds Sold. An asset representing the difference between the present value and
the face amount of bonds when the present value is less than the face amount.
STATE OF WEST VIRGINIA FORM 6
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - OTHER LIABILITIES
Agency Name: 0
1. Do you have any of the following LIABILITIES? NOTE: THIS FORM SHOULD BE COMPLETED
FOR ALL LINES WHICH INDIVIDUALLY
EXCEED $25,000.
Form of
Other Liabilities Categories Amount Payment *
Loans Payable
Escrow Deposits
Other (Please Describe):
Other Postemployment Benefits (OPEB)**
Court Settlement Monies
Advance Reservations
TOTAL $0
* Forms of payment - IGT's, Invoices, Off-System, or Other (describe)
** This is the unpaid portion due PEIA as of June 30th invoice.
PLEASE PROVIDE SUPPORTING DOCUMENTATION FOR ALL AMOUNTS LISTED ABOVE.
Do not include Claims and Judgments / Contingencies on this form (see form 1).
Please return completed forms to :
Prepared by
State of West Virginia
Financial Accounting Reporting Section
Preparer's E-mail address Building 17, 3rd Floor
2101 Washington Street East
Agency Telephone Number Charleston, WV 25305
Fax Number: 304-558-4084
Date FARS contact: Robert Seabolt 304-558-4083
Robert's email: Robert.P.Seabolt@wv.gov
STATE OF WEST VIRGINIA FORM 6
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - OTHER LIABILITIES
PURPOSE:
To collect data required for reporting and disclosure of all other liabilities not addressed in other closing forms,
which must be included in the State's annual financial statements.
ACCOUNTING POLICY:
GAAP requires that the liabilities of a government be accounted for and reported in the State's annual financial
statements. Agencies should complete the attached forms for all lines on the forms, which exceed $25,000
individually.
PROCEDURE:
For all liabilities other than those identified in the other sections of the closing package, please complete the
attached forms. Definitions are included in order to help you identify transactions or accounts that may fall within
this closing book section. Please attach supporting documentation to the closing book form.
DEFINITIONS FOR OTHER LIABILITIES ARE AS FOLLOWS:
Loans Payable A liability representing obligations borrowed for short periods of time, usually in
the form of notes payable. They may be secured or unsecured.
Escrow Deposits A liability representing amounts received by the State that are returnable upon
completion of future events.
Advance Reservations A liability representing the amounts received during the fiscal year for
reservations that will not take place until the following fiscal year.
Court Settlement Monies Monies received by the state as a result of court settlements. These amounts
must be returnable upon completion of a future event.
Other Post Employment Benefits (OPEB)
Accumulated liability due the WV Retiree Health Benefit Trust Fund as of the
June 30th billing statement.
NOTE: Form of Payment - identify the form of payment per liability amount. IGT payments are
intergovernmental transactions through the WVFIMS system. Off-System payments are where warrants are
processed through a system other than WVFIMS.
STATE OF WEST VIRGINIA FORM 7
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - OPERATING LEASES
Agency Name: 0
OPERATING LEASE DISCLOSURE FORM
Use this form to report total of non-cancelable operating leases in effect at June 30.
This includes only those leases that DO NOT CONTAIN bargain purchase options or
transfer of ownership clauses. Materiality level of $25,000 per lease agreement.
1. Lessor's Name:
2. Total operating lease payments made during FY 2010:
3. Future amounts required to pay operating leases:
Year Ending
June 30 Amount
2011
2012
2013
2014
2015
2016-2020
2021-2025
2026-2030
2031-2035
2036-2040
3a. Total Future Minimum Lease Payments $0
4. Description of assets rented through operating lease
Please Send This Form To:
Prepared By State of West Virginia
Financial Accounting Reporting Section
Building 17, 3rd Floor
Agency Telephone Number 2101 Washington Street East
Charleston, WV 25305
Fax Number 304-558-4084
Date FARS contact: Robert Seabolt 304-558-4083
Robert's email address: Robert.P.Seabolt@wv.gov
STATE OF WEST VIRGINIA FORM 7
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - OPERATING LEASES
PURPOSE
To obtain a comprehensive accumulation of agency's operating lease payments.
ACCOUNTING POLICY
For GAAP purposes, FASB Statement No. 13 requires the disclosure of all non-cancelable operating
leases for financial reporting purposes. An operating lease is essentially a rental agreement for the use of an
asset for a portion of its economic life in which ownership rights are not passed to the lessee. Operating leases
should not be confused with capital leases where the lessee assumes substantially all the risks and benefits
associated with the asset. Capital leases must meet one of the following criteria:
• The lease transfers ownership of the asset at the end of the lease term.
• The lease terms and conditions contain a bargain purchase option.
• The term of the lease is 75% or more of the estimated economic life of the leased
asset.
• The present value of the future minimum lease payments at the beginning of the lease
equals or exceeds 90% of the fair value of the asset.
LEASES WHICH DO NOT MEET THE CAPITAL LEASE CRITERIA ARE OPERATING LEASES.
PROCEDURE
Agencies should use the Operating Lease Disclosure Form to record all operating lease agreements
for which rental payments for the fiscal year ended June 30, 2010, exceeded $25,000.
Include on the form the total minimum lease payments due under current lease term for the next five
fiscal years and thereafter. To determine the minimum lease payments, compute the minimum amount of
payments that will be due for July 1 through June 30 or, if the monthly lease payments remain constant, multiply
the monthly payment by twelve.
INSTRUCTIONS
1) Record the Lessor’s name. This form should not include those leases that are with other
State agencies (e.g. Travel Management).
2) Record the amount of operating lease payments that were made during the fiscal year
ended June 30, 2010.
3) Record the minimum annual lease payments due under current lease terms for each of
the next five fiscal years ended June 30. Be certain to include only rental for the term of
the current lease. For example, if the lease expires on June 30, 2010, no amount would
be recorded for the subsequent years.
For operating leases expiring after FY 2015, enter lease payments due for five year
increments beginning fiscal year 2016.
a) Foot the total "Future Minimum Lease Payments" line.
4) Record a short description of each asset rented through an operating lease agreement for
which the FY 2010 lease payments exceeded $25,000.
If the agency does not have any operating leases, check N/A on the transmittal.
STATE OF WEST VIRGINIA FORM 7
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - OPERATING LEASES
FORM 8
STATE OF WEST VIRGINIA
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - MULTI-YEAR REVENUES
AGENCY NAME: 0
Multi-year revenue is received in one fiscal year (ex. 2010) that covers services provided for more than one fiscal year. (Ex. A business owner purchases
a two-year business registration in fiscal year 2009.) Please list all types of multi-year revenue over $25,000 collected by your agency.
Describe your system currently in place to track multi-year revenue.
A B C D E F=B+C-D-E G H I
Description 7/1/2009 Additional Gross Less Revenue Earned Less Revenue Refunds 6/30/2010 Ending Deposited to: Gross Revenue
of Multi-Year Beginning Balance Unearned Revenue in FY 2010 but Received Paid Out in FY 2010 but Balance of WVFIMS Fund WVFIMS State-Level Earned and
Revenue of Unearned Revenue Received in FY 2010 Prior to FY 2010 Received Prior to FY 2010 Unearned Revenue Number Revenue Source Received in FY 2010
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Total 0 0 0 0 0 0
Please Send This Form To:
PREPARED BY
State of West Virginia
Financial Accounting Reporting Section
Building 17, 3rd Floor
TELEPHONE NUMBER 2101 Washington Street East
Charleston, WV 25305
Fax Number 304-558-4084
DATE FARS contact: Jane Shinn 304-558-4083
Jane's email is Jane.A.Shinn@wv.gov
FORM 8
STATE OF WEST VIRGINIA
DEPARTMENT OF ADMINISTRATION - FINANCE DIVISION
FINANCIAL ACCOUNTING AND REPORTING SECTION
GAAP REPORTING FORM - MULTI-YEAR REVENUES
PURPOSE
To collect data on the multi-year revenues, this must be included in the State’s annual financial statements.
ACCOUNTING POLICY
The Governmental Accounting Standards Board (GASB) issued GASB Statement No. 34 requiring multi -year revenues received by the State be reported in the State's annual financial statements.
DEFINITION
Multi-year revenue is received in one fiscal year (ex. 2010) that covers services provided for more than one fiscal year. (Ex. A car owner purchases a two-year vehicle registration in fiscal year 2010.)
PROCEDURE
Agencies should use the Multi-year Revenue form to record all multi-year revenue for the fiscal year ended June 30, 2010.
INSTRUCTIONS
Agencies should use the Multi-Year Revenue form to list all multi-year revenue as of June 30, 2010.
1. Describe your system currently in place to tract multi-year revenue.
2. Describe the multi-year revenue in column A.
3. Enter the 07/01/2009 beginning balance of the unearned revenue in column B.
4. Enter the additional gross unearned revenue received in FY 2010 in column C.
5. Enter the revenue earned in FY 2010 but received prior to FY 2010 in column D.
6. Enter the revenue refunds paid out in FY 2010 but received prior to FY 2010 in column E.
7. The 6/30/2010 ending balance of unearned revenue will be calculated in column F.
8. Enter the WVFIMS fund number where the unearned revenue was deposited in column G.
9. Enter the WVFIMS state level revenue source code used when the unearned revenue was deposited in the above WVFIMS fund in col umn H.
10. Enter the gross revenue earned and received in FY 2010 revenue in column I.
