Wv Pay Card Form - West Virginia State Auditor'S Office Epayments Division
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2WV PAY CARD FORM INSTRUCTIONS
In order to process a WV Pay Card request, the following employee information must be provided:
1. First and Last Name
2. EPICS Number & wvOASIS Employee ID (This can be provided by your State Agency Payroll Department.)
(Phase one employees must supply both numbers!)
3. Social Security Number
4. Home Phone Number
5. Mailing Address (This address must match the address on file in EPICS.)
6. Date of Birth
7. Employee's Signature and Date
Once the information above has been provided, forward request to your State Agency Payroll Department for
completion.
To complete a WV Pay Card request, the State Agency Payroll Department must do the following:
1. Provide the State Agency Name
2. Provide Phone Number
3. Review the form and make sure it has been completed properly.
4. Sign and Date the form.
Once the information above has been completed, forward the form to the West Virginia State Auditor's Office,
ePayments Division.
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