Commonwealth of Virginia s12

12/05/2011

FIPS ChartField Maintenance Form SetID: STATE Entered FIPS Value:______By:______Date:______

Effective Date: ______Status: Active Inactive (An initial date of 01/01/1901 is required for new FIPS)

Description:______(This is a required field and is restricted to 30 characters.) Short Description:______Budgetary Only: (This is a required field and is restricted to 10 characters.) (Check box if the FIPS is only used on Budget Transactions.)

Attributes: Attribute Attribute Value CODE TYPE City County Town

#VDOT COUNTY ID: ______(Enter the FMSII value for the locality)

*Required attribute Trees: Review and update if necessary: N/A

Combination Edit: Review rules listed and update if necessary: #CSCFIPCMBO

Long Description: ______(Use to further describe the FIPS’ purpose/use;optional.)

# - VDOT specific

Requesting Agency: ______

Requester:______Date:______Approver:______Date:______