|
Field Name
|
Type
|
Size
|
Position
|
Required/
Optional
|
Remarks
|
|
Employee SSN |
N |
9 |
001-009 |
Required |
As
Reported by employee |
|
Employee First Name |
A |
16 |
010-025 |
Required |
At
least one character
No special characters |
|
Employee Middle Name |
A |
16 |
026-041 |
Optional |
If
non-blank, must be at least one character
No
special characters |
|
Employee Last Name |
A |
30 |
042-071 |
Required |
At
least one character
No
special characters, except for hyphen |
|
Employee Street Address (line 1) |
A/N |
40 |
072-111 |
Required |
Non-blank |
|
Employee Street Address (line 2) |
A/N |
40 |
112-151 |
Optional |
If
address line is less than 40 characters, do not
concatenate into one line |
|
Employee Street Address (line 3) |
A/N |
40 |
152-191 |
Optional |
|
|
Employee City |
A |
25 |
192-216 |
Required |
At
least two characters
No
special characters, except for hyphen |
|
Employee State |
A |
2 |
217-218 |
Required |
Valid
state or territory abbreviation |
|
Employee Zip (1) |
N |
5 |
219-223 |
Required |
Must be
numeric |
|
Employee Zip (2) |
A/N |
4 |
224-227 |
Optional |
If
present, must be numeric |
|
Employee Foreign Country Code |
A/N |
2 |
228-229 |
Required, if foreign address |
Refer
to US Dept of Commerce FIPS Code manual, Nat'l Institute
of Standards and Technology, FIPS PUB 10-4 (April 1995) |
|
Employee Foreign Country Name |
A/N |
25 |
230-254 |
Optional |
If
present, at least two characters |
|
Employee Foreign Zip Code |
A/N |
15 |
255-269 |
Optional |
|
|
Employee Date of Birth |
A/N |
8 |
270-277 |
Optional |
If
present, must be numeric
Format - YYYYMMDD |
|
Employee Date of Hire |
A/N |
8 |
278-285 |
Required |
If
present, must be numeric
Format - YYYYMMDD |
|
Employee State of Hire |
A |
2 |
286-287 |
Optional |
Valid
state or territory abbreviation |
|
Employer Federal EIN |
N |
9 |
288-296 |
Required |
Federal
Employer Identification Number |
|
Employer State EIN |
A/N |
12 |
297-308 |
Optional |
If FEIN
is not available, send the State EIN
If
present and less than 12 characters, left justify |
|
Employer Name |
A/N |
45 |
309-353 |
Required |
At
least two characters |
|
Employer Street Address (line 1) |
A/N |
40 |
354-393 |
Required |
FEIN
address from W4 |
|
Employer Street Address (line 2) |
A/N |
40 |
394-433 |
Optional |
If
address line is less than 40 characters, do not
concatenate into one line |
|
Employer Street Address (line 3) |
A/N |
40 |
434-473 |
Optional |
|
|
Employer City |
A |
25 |
474-498 |
Required |
At
least two characters |
|
Employer State |
A |
2 |
499-500 |
Required |
Valid
state or territory abbreviation |
|
Employer Zip (1) |
N |
5 |
501-505 |
Required |
Must be
numeric |
|
Employer Zip (2) |
A/N |
4 |
506-509 |
Optional |
If
present, must be numeric |
|
Employer Foreign Country Code |
A/N |
2 |
510-511 |
Required, if foreign address |
Refer
to US Dept of Commerce FIPS code manual, Nat'l Institute
of Standards and Technology, FIPS PUB 10-4 (April 1995) |
|
Employer Foreign Country Name |
A/N |
25 |
512-536 |
Optional |
If
present, at least two characters |
|
Employer Foreign Zip Code |
A/N |
15 |
537-551 |
Optional |
|
|
Employer Opt Street Address (line 1) |
A/N |
40 |
552-591 |
Optional |
The
optional address will be blank if only collecting one
address. If there is a second address, it should be the
address where child support orders should be sent. |
|
Employer Opt Street Address (line 2) |
A/N |
40 |
592-631 |
Optional |
If
address is less than 40 characters, do not concatenate
into one line |
|
Employer Opt Street Address (line) |
A/N |
40 |
632-671 |
Optional |
|
|
Employer Opt City |
A |
25 |
672-696 |
Optional |
If
present, at least two characters |
|
Employer Opt State |
A |
2 |
697-698 |
Optional |
If
present, valid state or territory abbreviation |
|
Employer Opt Zip (1) |
A |
5 |
699-703 |
Optional |
If
present, must be numeric |
|
Employer Opt Zip (2) |
A |
4 |
704-707 |
Optional |
If
present, must be numeric |
|
Employer Opt Foreign Country Code |
A/N |
2 |
708-709 |
Optional |
Refer
to US Dept of Commerce FIPS code manual, Nat'l Institute
of Standards and Technology, FIPS PUB 10-4 (April, 1995) |
|
Employer Opt Foreign Country Name |
A/N |
25 |
710-734 |
Optional |
If
present, at least two characters |
|
Employer Opt Foreign Zip Code |
A/N |
15 |
735-749 |
Optional |
|
|
Federal
Filler |
A |
50 |
750-799 |
|
Spaces
- to be used for future Federal versions |
|
State
Filler |
A |
101 |
800-900 |
|
Spaces
- to be used for future State versions |
|
Type A, A/N = Alpha, Alpha/Numeric - left justified, blank
filled
Type N = Numeric, right justified, zero filled, unsigned |