Forms

Accounting
Document Date Format
1. Advantage Journal Template (Single or multi-page) 09/20/2017 Excel
2. Reporting Unit Request - Single Request 12/07/2015 Excel
3. Reporting Unit Request - Multiple Request 12/07/2015 Excel
4. Cash Management and Estimated Revenue Request 06/28/2019 Excel
5. Petty Cash Authorization (New) 08/08/2013 PDF
6. Petty Cash Authorization (Update) 08/08/2013 PDF
7. Petty Cash and Change Account Reconciliation Revised Forms 07/02/2018 Excel
8. Signature Authorization
   (For Advantage Accounts Payable and Journal Voucher OSC Approval)
09/11/2019 PDF
Vendor
Document Date Format
1. Vendor Activation/Change    (Form Instructions)
 (aka State of Maine Substitute W9)
11/17/2014 PDF
2. Vendor Deactivation 01/21/2010 PDF
Direct Deposit / EFT
Document Date Format
1. Direct Deposit / Electronic Funds Transfer Activation/Change
 Direct Deposit/EFT Guidelines   DD/EFT Form Instructions
(Note: If you are Paymode/Clareon vendor, you do not need to complete this form. Instead, please contact Paymode at 1-877-443-6944.)
03/21/2019 PDF
2. Direct Deposit / Electronic Funds Transfer Deactivation 04/16/2013 PDF

Effective May 11, 2015, MaineCare providers must access the Maine Integrated Health Management System (MIHMS) at the following link  https://mainecare.maine.gov/ProviderHomePage.aspx to register for Electronic Funds Transfer (EFT).  EFT Registration For MaineCare providers is now only available as part of Provider Enrollment or Provider Maintenance on the MIHMS Portal.

Payroll
Document Date Format
1. Employee Direct Deposit Request 04/17/2008 PDF
2. Duplicate W-2 Request 11/17/2005 PDF
3. Replacement Check Request (SAL/SUP/PAY) 08/20/2009 PDF

4. Lost/Damaged Check Request (LOS) **Use for check being reissued**

Note: Please do not use this form's accounting codes on cash receipt if you are not planning to resissue payment.

08/20/2009 PDF

5. Payment Reversal Request **Use for check being stopped; no reissue**

11/17/2005 PDF
6. State Reimbursement 10/08/2019 PDF
7. W-4 Employees Withholding Certificate 2017 PDF
8. W-4ME State Employees Withholding Certificate 2017 PDF
9. Security Application (HR System & MEPERS) 03/08/2012 PDF
10. Security Application (MS-TAMS) 03/08/2012 PDF
11. MFASIS HR Transfer Request Form 06/10/2016 PDF
12. Agency Deduction Override Form 06/10/2016 Excel
13. Agency Regular Pay Form 06/10/2016 Excel
14. Agency Special Pay Form 06/10/2016 Excel
15. Longevity Merit Report of Lost Earnings 06/10/2016 Excel
Security Applications
Document Date Format
1. Advantage Security Application (Includes Fortis)
      (Form Instructions)
02/01/2016 PDF
2. Advantage CMS Security Application (Case Management - NEW!)  08/05/2019 PDF
3. GQL Data Warehouse, SQL Financial Cube & OACS DAFS Analytics Security Application 10/04/2019 PDF
Travel
Document Date Format
1. Advance Voucher & Out of State Travel Request 02/07/2019 Excel / PDF
2. Air Travel Quote Submission 12/12/2006 Excel / PDF
3. Expense Voucher 06/14/2016 Excel / PDF
Other
Document Date Format

1. For Internal State Use Only W9 State Completed (State is receiver of funds.)
   Note: Agencies are welcome to sign on behalf of.

This form is NOT to be used by outside vendors or VSS. Please use Substitute W9 under Vendor Forms.

04/01/2019 PDF

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