<p> 12/05/2011 </p><p>FIPS ChartField Maintenance Form SetID: STATE Entered FIPS Value:______By:______Date:______</p><p>Effective Date: ______Status: Active Inactive (An initial date of 01/01/1901 is required for new FIPS)</p><p>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.)</p><p>Attributes: Attribute Attribute Value CODE TYPE City County Town</p><p>#VDOT COUNTY ID: ______(Enter the FMSII value for the locality)</p><p>*Required attribute Trees: Review and update if necessary: N/A </p><p>Combination Edit: Review rules listed and update if necessary: #CSCFIPCMBO </p><p>Long Description: ______(Use to further describe the FIPS’ purpose/use;optional.)</p><p># - VDOT specific</p><p>Requesting Agency: ______</p><p>Requester:______Date:______Approver:______Date:______</p>