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{"sheet":"1095C Template","index":0,"n_rows":11,"n_cols":570,"rows_kept":11,"cut":false,"hidden":false,"merged":[]}
["2023 Tax Year (Do Not Delete)"]
["Name of Employer 1 (Box 7)","Name of Employer 2 (Box 7)","Employer Address 1 (Box 9)","Employer Address 2 (Box 9)","Employer City (Box 11)","Employer State  (Box 12)","Employer Zip (Box 13)","Employer Foreign Address Indicator","Employer Foreign State Name (Box 12)","Employer Foreign Postal Code (Box 13)","Employer Foreign Country Code (Box 13)","1094 Contact First Name","1094 Contact Middle Initial","1094 Contact Last Name","1094 Contact Suffix","1095 Contact Phone (Box 10)","1095 Contact Phone Ext (Box 10)","1094 Contact Phone","1094 Contact Phone Ext","Employer Identification Number (Box 8)","Employer Misc Search One","Employer Misc Search Two","Employee Social Security Number (Box 2)","Employee First Name (Box 1)","Employee Middle Initial (Box 1)","Employee Last Name (Box 1)","Employee Suffix (Box 1)","Employee Address 1 (Box 3)","Employee Address 2 (Box 3)","Employee City (Box 4)","Employee State (Box 5)","Employee Zip (Box 6)","ACA State Filing","Employee Foreign Address Indicator","Employee Foreign State Name (Box 5)","Employee Foreign Postal Code (Box 6)","Employee Foreign Country Code (Box 6)","Employee Email (Online Retrieval)","Employee Misc Search","Employee Age","Plan Start Month","All 12 Month Offer Of Coverage (Line 14)","Jan Offer Of Coverage (Line 14)","Feb Offer Of Coverage (Line 14)","Mar Offer Of Coverage (Line 14)","Apr Offer Of Coverage (Line 14)","May Offer Of Coverage (Line 14)","Jun Offer Of Coverage (Line 14)","Jul Offer Of Coverage (Line 14)","Aug Offer Of Coverage (Line 14)","Sep Offer Of Coverage (Line 14)","Oct Offer Of Coverage (Line 14)","Nov Offer Of Coverage (Line 14)","Dec Offer Of Coverage (Line 14)","Employee Required Contribution For All 12 Months (Line 15)","Employee Required Contribution For Jan (Line 15)","Employee Required Contribution For Feb (Line 15)","Employee Required Contribution For Mar (Line 15)","Employee Required Contribution For Apr (Line 15)","Employee Required Contribution For May (Line 15)","Employee Required Contribution For Jun (Line 15)","Employee Required Contribution For Jul (Line 15)","Employee Required Contribution For Aug (Line 15)","Employee Required Contribution For Sep (Line 15)","Employee Required Contribution For Oct (Line 15)","Employee Required Contribution For Nov (Line 15)","Employee Required Contribution For Dec (Line 15)","Safe Harbor And Other Relief For All 12 Months (Line 16)","Safe Harbor And Other Relief For Jan (Line 16)","Safe Harbor And Other Relief For Feb (Line 16)","Safe Harbor And Other Relief For Mar (Line 16)","Safe Harbor And Other Relief For Apr (Line 16)","Safe Harbor And Other Relief For May (Line 16)","Safe Harbor And Other Relief For Jun (Line 16)","Safe Harbor And Other Relief For Jul (Line 16)","Safe Harbor And Other Relief For Aug (Line 16)","Safe Harbor And Other Relief For Sep (Line 16)","Safe Harbor And Other Relief For Oct (Line 16)","Safe Harbor And Other Relief For Nov (Line 16)","Safe Harbor And Other Relief For Dec (Line 16)","Zip Code For All 12 Months (Line 17)","Zip Code For Jan (Line 17)","Zip Code For Feb (Line 17)","Zip Code For Mar (Line 17)","Zip Code For Apr (Line 17)","Zip Code For May (Line 17)","Zip Code For Jun (Line 17)","Zip Code For Jul (Line 17)","Zip Code For Aug (Line 17)","Zip Code For Sep (Line 17)","Zip Code For Oct (Line 17)","Zip Code For Nov (Line 17)","Zip Code For Dec (Line 17)","Covered Individual Checkbox (Part III)","Individual SSN Or TIN (b1)","DOB (c1)","First Name (a1)","Middle Initial (a1)","Last Name (a1)","Suffix (a1)","Covered 12 Months (d1)","Jan (e1)","Feb (e1)","Mar (e1)","Apr (e1)","May (e1)","Jun (e1)","Jul (e1)","Aug (e1)","Sep (e1)","Oct (e1)","Nov (e1)","Dec (e1)","Individual SSN Or TIN (b2)","DOB (c2)","First Name (a2)","Middle Initial (a2)","Last Name (a2)","Suffix (a2)","Covered 12 Months (d2)","Jan (e2)","Feb (e2)","Mar (e2)","Apr (e2)","May (e2)","Jun (e2)","Jul (e2)","Aug (e2)","Sep (e2)","Oct (e2)","Nov (e2)","Dec (e2)","Individual SSN Or TIN (b3)","DOB (c3)","First Name (a3)","Middle Initial (a3)","Last Name (a3)","Suffix (a3)","Covered 12 Months (d3)","Jan (e3)","Feb (e3)","Mar (e3)","Apr (e3)","May (e3)","Jun (e3)","Jul (e3)","Aug (e3)","Sep (e3)","Oct (e3)","Nov (e3)","Dec (e3)","Individual SSN Or TIN (b4)","DOB (c4)","First Name (a4)","Middle Initial (a4)","Last Name (a4)","Suffix (a4)","Covered 12 Months (d4)","Jan (e4)","Feb (e4)","Mar (e4)","Apr (e4)","May (e4)","Jun (e4)","Jul (e4)","Aug (e4)","Sep (e4)","Oct (e4)","Nov (e4)","Dec (e4)","Individual SSN Or TIN (b5)","DOB (c5)","First Name (a5)","Middle Initial (a5)","Last Name (a5)","Suffix (a5)","Covered 12 Months (d5)","Jan (e5)","Feb (e5)","Mar (e5)","Apr (e5)","May (e5)","Jun (e5)","Jul (e5)","Aug (e5)","Sep (e5)","Oct (e5)","Nov (e5)","Dec (e5)","Individual SSN Or TIN (b6)","DOB (c6)","First Name (a6)","Middle Initial (a6)","Last Name (a6)","Suffix (a6)","Covered 12 Months (d6)","Jan (e6)","Feb (e6)","Mar (e6)","Apr (e6)","May (e6)","Jun (e6)","Jul (e6)","Aug (e6)","Sep (e6)","Oct (e6)","Nov (e6)","Dec (e6)","Individual SSN Or TIN (b7)","DOB (c7)","First Name (a7)","Middle Initial (a7)","Last Name (a7)","Suffix (a7)","Covered 12 Months (d7)","Jan (e7)","Feb (e7)","Mar (e7)","Apr (e7)","May (e7)","Jun (e7)","Jul (e7)","Aug (e7)","Sep (e7)","Oct (e7)","Nov (e7)","Dec (e7)","Individual SSN Or TIN (b8)","DOB (c8)","First Name (a8)","Middle Initial (a8)","Last Name (a8)","Suffix (a8)","Covered 12 Months (d8)","Jan (e8)","Feb (e8)","Mar (e8)","Apr (e8)","May (e8)","Jun (e8)","Jul (e8)","Aug (e8)","Sep (e8)","Oct (e8)","Nov (e8)","Dec (e8)","Individual SSN Or TIN (b9)","DOB (c9)","First Name (a9)","Middle Initial (a9)","Last Name (a9)","Suffix (a9)","Covered 12 Months (d9)","Jan (e9)","Feb (e9)","Mar (e9)","Apr (e9)","May (e9)","Jun (e9)","Jul (e9)","Aug (e9)","Sep (e9)","Oct (e9)","Nov (e9)","Dec (e9)","Individual SSN Or TIN (b10)","DOB (c10)","First Name (a10)","Middle Initial (a10)","Last Name (a10)","Suffix (a10)","Covered 12 Months (d10)","Jan (e10)","Feb (e10)","Mar (e10)","Apr (e10)","May (e10)","Jun (e10)","Jul (e10)","Aug (e10)","Sep (e10)","Oct (e10)","Nov (e10)","Dec (e10)","Individual SSN Or TIN (b11)","DOB (c11)","First Name (a11)","Middle Initial (a11)","Last Name (a11)","Suffix (a11)","Covered 12 Months (d11)","Jan (e11)","Feb (e11)","Mar (e11)","Apr (e11)","May (e11)","Jun (e11)","Jul (e11)","Aug (e11)","Sep (e11)","Oct (e11)","Nov (e11)","Dec (e11)","Individual SSN Or TIN (b12)","DOB (c12)","First Name (a12)","Middle Initial (a12)","Last Name (a12)","Suffix (a12)","Covered 12 Months (d12)","Jan (e12)","Feb (e12)","Mar (e12)","Apr (e12)","May (e12)","Jun (e12)","Jul (e12)","Aug (e12)","Sep (e12)","Oct (e12)","Nov (e12)","Dec (e12)","Individual SSN Or TIN (b13)","DOB (c13)","First Name (a13)","Middle Initial (a13)","Last Name (a13)","Suffix (a13)","Covered 12 Months (d13)","Jan (e13)","Feb (e13)","Mar (e13)","Apr (e13)","May (e13)","Jun (e13)","Jul (e13)","Aug (e13)","Sep (e13)","Oct (e13)","Nov (e13)","Dec (e13)","Individual SSN Or TIN (b14)","DOB (c14)","First Name (a14)","Middle Initial (a14)","Last Name (a14)","Suffix (a14)","Covered 12 Months (d14)","Jan (e14)","Feb (e14)","Mar (e14)","Apr (e14)","May (e14)","Jun (e14)","Jul (e14)","Aug (e14)","Sep (e14)","Oct (e14)","Nov (e14)","Dec (e14)","Individual SSN Or TIN (b15)","DOB (c15)","First Name (a15)","Middle Initial (a15)","Last Name (a15)","Suffix (a15)","Covered 12 Months (d15)","Jan (e15)","Feb (e15)","Mar (e15)","Apr (e15)","May (e15)","Jun (e15)","Jul (e15)","Aug (e15)","Sep (e15)","Oct (e15)","Nov (e15)","Dec (e15)","Individual SSN Or TIN (b16)","DOB (c16)","First Name (a16)","Middle Initial (a16)","Last Name (a16)","Suffix (a16)","Covered 12 Months (d16)","Jan (e16)","Feb (e16)","Mar (e16)","Apr (e16)","May (e16)","Jun (e16)","Jul (e16)","Aug (e16)","Sep (e16)","Oct (e16)","Nov (e16)","Dec (e16)","Individual SSN Or TIN (b17)","DOB (c17)","First Name (a17)","Middle Initial (a17)","Last Name (a17)","Suffix (a17)","Covered 12 Months (d17)","Jan (e17)","Feb (e17)","Mar (e17)","Apr (e17)","May (e17)","Jun (e17)","Jul (e17)","Aug (e17)","Sep (e17)","Oct (e17)","Nov (e17)","Dec (e17)","Individual SSN Or TIN (b18)","DOB (c18)","First Name (a18)","Middle Initial (a18)","Last Name (a18)","Suffix (a18)","Covered 12 Months (d18)","Jan (e18)","Feb (e18)","Mar (e18)","Apr (e18)","May (e18)","Jun (e18)","Jul (e18)","Aug (e18)","Sep (e18)","Oct (e18)","Nov (e18)","Dec (e18)","Individual SSN Or TIN (b19)","DOB (c19)","First Name (a19)","Middle Initial (a19)","Last Name (a19)","Suffix (a19)","Covered 12 Months (d19)","Jan (e19)","Feb (e19)","Mar (e19)","Apr (e19)","May (e19)","Jun (e19)","Jul (e19)","Aug (e19)","Sep (e19)","Oct (e19)","Nov (e19)","Dec (e19)","Individual SSN Or TIN (b20)","DOB (c20)","First Name (a20)","Middle Initial (a20)","Last Name (a20)","Suffix (a20)","Covered 12 Months (d20)","Jan (e20)","Feb (e20)","Mar (e20)","Apr (e20)","May (e20)","Jun (e20)","Jul (e20)","Aug (e20)","Sep (e20)","Oct (e20)","Nov (e20)","Dec (e20)","Individual SSN Or TIN (b21)","DOB (c21)","First Name (a21)","Middle Initial (a21)","Last Name (a21)","Suffix (a21)","Covered 12 Months (d21)","Jan (e21)","Feb (e21)","Mar (e21)","Apr (e21)","May (e21)","Jun (e21)","Jul (e21)","Aug (e21)","Sep (e21)","Oct (e21)","Nov (e21)","Dec (e21)","Individual SSN Or TIN (b22)","DOB (c22)","First Name (a22)","Middle Initial (a22)","Last Name (a22)","Suffix (a22)","Covered 12 Months (d22)","Jan (e22)","Feb (e22)","Mar (e22)","Apr (e22)","May (e22)","Jun (e22)","Jul (e22)","Aug (e22)","Sep (e22)","Oct (e22)","Nov (e22)","Dec (e22)","Individual SSN Or TIN (b23)","DOB (c23)","First Name (a23)","Middle Initial (a23)","Last Name (a23)","Suffix (a23)","Covered 12 Months (d23)","Jan (e23)","Feb (e23)","Mar (e23)","Apr (e23)","May (e23)","Jun (e23)","Jul (e23)","Aug (e23)","Sep (e23)","Oct (e23)","Nov (e23)","Dec (e23)","Individual SSN Or TIN (b24)","DOB (c24)","First Name (a24)","Middle Initial (a24)","Last Name (a24)","Suffix (a24)","Covered 12 Months (d24)","Jan (e24)","Feb (e24)","Mar (e24)","Apr (e24)","May (e24)","Jun (e24)","Jul (e24)","Aug (e24)","Sep (e24)","Oct (e24)","Nov (e24)","Dec (e24)","Individual SSN Or TIN (b25)","DOB (c25)","First Name (a25)","Middle Initial (a25)","Last Name (a25)","Suffix (a25)","Covered 12 Months (d25)","Jan (e25)","Feb (e25)","Mar (e25)","Apr (e25)","May (e25)","Jun (e25)","Jul (e25)","Aug (e25)","Sep (e25)","Oct (e25)","Nov (e25)","Dec (e25)","Reprint Reason"]
["Example Test Company",null,"123 Street",null,"Grand Rapids","MI","495011157",null,null,null,null,"Fred",null,"Dent",null,"5559876543",null,1112223333,4321,111111112,null,null,111226648,"John","A","Doe","Sr","555 Eastern St",null,"Grand Rapids","MI","495017448","CA NJ DC RI",null,null,null,"","emp@mail.com",null,null,"01","1E",null,null,null,null,null,null,null,null,null,null,null,null,"101.50",null,null,null,null,null,null,null,null,null,null,null,null,"2C",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"X","111226648",null,"John","A","Doe","Sr",true,null,null,null,null,null,null,null,null,null,null,null,null,"111226650",null,"John","A","Doe","Jr",true,null,null,null,null,null,null,null,null,null,null,null,null,"111226651",null,"Helen","J","Doe",null,true]
["Example Test Company",null,"123 Street",null,"Grand Rapids","MI","495011157",null,null,null,null,"Fred",null,"Dent",null,"5559876543",null,1112223333,4321,111111112,null,null,111223333,"Jane","F","Smith",null,"753 Circle Dr","Apt 2786","Grand Rapids","MI",49501,null,null,null,null,null,"empa@mail.com",null,null,"01","1E",null,null,null,null,null,null,null,null,null,null,null,null,"101.50",null,null,null,null,null,null,null,null,null,null,null,null,"2C",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"X","111223333",null,"Jane","F","Smith",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"111223335",null,"James","R","Smith",null,true,null,null,null,null,null,null,null,null,null,null,null,null,null,"04/15/2012","Alex","R","Smith",null,true]
["Example Test Company",null,"123 Street",null,"Grand Rapids","MI","495011157",null,null,null,null,"Fred",null,"Dent",null,"5559876543",null,1112223333,4321,111111112,null,null,222334444,"Pam","J","West",null,"222 Street",null,"Grand Rapids","MI",49501,"NJ CA",null,null,null,null,"empb@mail.com",null,null,"01","1E",null,null,null,null,null,null,null,null,null,null,null,null,"101.50"]
["Example Test Company",null,"123 Street",null,"Grand Rapids","MI","495011157",null,null,null,null,"Fred",null,"Dent",null,"5559876543",null,1112223333,4321,111111112,null,null,333445555,"Jim","P","Johnson",null,"N111 County A",null,"Grand Rapids","MI","495014425",null,null,null,null,null,"empc@mail.com",null,null,"01",null,"1H","1H","1H","1H","1H","1E","1E","1E","1E","1E","1E","1E",null,null,null,null,null,null,"101.50","101.50","101.50","101.50","101.50","101.50","101.50",null,"2A","2A","2A","2D","2D","2C","2C","2C","2C","2C","2C","2C",null,null,null,null,null,null,null,null,null,null,null,null,null,"X","333445555",null,"Jim","P","Johnson",null,null,null,null,null,null,null,true,true,true,true,true,true,true,null,"05/17/2011","Jasper",null,"Johnson",null,null,null,null,null,null,"TRUE",true,true,true,true,true,true,true,"333445558",null,"Timothy",null,"Johnson",null,null,null,null,null,null,null,true,true,true,true,true,true,true]
["Sample Import Company","Company Name Two","456 West Ave","Suite 400","Green Bay","WI",54301,null,null,null,null,"Jane",null,"Art",null,"5556549871",null,5554446666,null,222222223,null,null,115555555,"Fred","J","Home",null,"123 Professional Dr",null,"Green Bay","WI",54301,"CA",null,null,null,null,"empd@mail.com",null,null,"01",null,"1H","1H","1H","1H","1H","1H","1A","1A","1A","1A","1A","1A",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2A","2A","2A","2A","2A","2D","2C","2C","2C","2C","2C","2C",null,null,null,null,null,null,null,null,null,null,null,null,null,"FALSE"]
["Sample Import Company","Company Name Two","456 West Ave","Suite 400","Green Bay","WI",54301,null,null,null,null,"Jane",null,"Art",null,"5556549871",null,5554446666,null,222222223,null,null,116666666,"Sam","J","Away",null,"444 Sunset Blvd","Suite 5B","Green Bay","WI",54301,"NJ RI",null,null,null,null,"empe@mail.com",null,null,"01","1A",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2C",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"FALSE"]
["Sample Import Company","Company Name Two","456 West Ave","Suite 400","Green Bay","WI",54301,null,null,null,null,"Jane",null,"Art",null,"5556549871",null,5554446666,null,222222223,null,null,117777777,"Joe","P","Win",null,"456 Main St",null,"Green Bay","WI",54301,"DC",null,null,null,null,"empf@mail.com",null,null,"01","1A",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"FALSE"]
["Sample Import Company","Company Name Two","456 West Ave","Suite 400","Green Bay","WI",54301,null,null,null,null,"Jane",null,"Art",null,"5556549871",null,5554446666,null,222222223,null,null,444556666,"Jane","W","Doe",null,"1222 Avenue",null,"Green Bay","WI",54301,"RI",null,null,null,null,"empg@mail.com",null,null,"01","1A",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2C",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"FALSE"]
["Sample Import Company","Company Name Two","456 West Ave","Suite 400","Green Bay","WI",54301,null,null,null,null,"Jane",null,"Art",null,"5556549871",null,5554446666,null,222222223,null,null,555667777,"Sally","A","Jones",null,"1555 W 51st St",null,"Green Bay","WI",54301,"NJ",null,null,null,null,"emph@mail.com",null,null,"01",null,"1H","1H","1H","1H","1H","1H","1H","1H","1H","1H","1H","1A",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2A","2A","2A","2A","2A","2A","2A","2A","2A","2A","2D","2C",null,null,null,null,null,null,null,null,null,null,null,null,null,"FALSE"]

{"sheet":"1094C Template (Optional)","index":1,"n_rows":3,"n_cols":153,"rows_kept":3,"cut":false,"hidden":false,"merged":[]}
["Name Of Employer 1 (Box 1)","Name Of Employer 2 (Box 1)","Employer Address 1 (Box 3)","Employer Address 2 (Box 3)","Employer City (Box 4)","Employer State (Box 5)","Employer Zip (Box 6)","Employer Foreign Address Indicator","Employer Foreign State Name (Box 5)","Employer Foreign Postal Code (Box 6)","Employer Foreign Country Code (Box 6)","1094 Contact First Name (Box 7)","1094 Contact Middle Initial (Box 7)","1094 Contact Last Name (Box 7)","1094 Contact Suffix (Box 7)","1094 Contact Phone (Box 8)","1094 Contact Phone Ext (Box 8)","Employer Identification Number (Box 2)","Govt Entity Name 1 (Box 9)","Govt Entity Name 2 (Box 9)","Govt Entity Employer Identification Number (Box 10)","Govt Entity Address 1 (Box 11)","Govt Entity Address 2 (Box 11)","Govt Entity City (Box 12)","Govt Entity State (Box 13)","Govt Entity Zip (Box 14)","Govt Entity Foreign Address Indicator","Govt Entity Foreign State Name (Box 13)","Govt Entity Foreign Postal Code (Box 14)","Govt Entity Foreign Country Code (Box 14)","Govt Entity Contact First Name (Box 15)","Govt Entity Contact Middle Initial (Box 15)","Govt Entity Contact Last Name (Box 15)","Govt Entity Contact Suffix (Box 15)","Govt Entity Contact Phone (Box 16)","Govt Entity Contact Phone Ext (Box 16)","Authoritative Transmittal Checkbox (Line 19)","Total 1095-C For Employer (Line 20)","Aggregated Group Member Checkbox (Line 21)","Qualifying Offer Method Checkbox (Line 22a)","98% Offer Method Checkbox (Line 22d)","All Yr Min Essential Coverage Checkbox (23a)","All Yr Full-Time Employee Count (23b)","All Yr Employee Count (23c)","All Yr Aggregated Group Checkbox (23d)","Jan Min Essential Coverage Checkbox (24a)","Jan Full-Time Employee Count (24b)","Jan Employee Count (24c)","Jan Aggregated Group Checkbox (24d)","Feb Min Essential Coverage Checkbox (25a)","Feb Full-Time Employee Count (25b)","Feb Employee Count (25c)","Feb Aggregated Group Checkbox (25d)","Mar Min Essential Coverage Checkbox (26a)","Mar Full-Time Employee Count (26b)","Mar Employee Count (26c)","Mar Aggregated Group Checkbox (26d)","Apr Min Essential Coverage Checkbox (27a)","Apr Full-Time Employee Count (27b)","Apr Employee Count (27c)","Apr Aggregated Group Checkbox (27d)","May Min Essential Coverage Checkbox (28a)","May Full-Time Employee Count (28b)","May Employee Count (28c)","May Aggregated Group Checkbox (28d)","Jun Min Essential Coverage Checkbox (29a)","Jun Full-Time Employee Count (29b)","Jun Employee Count (29c)","Jun Aggregated Group Checkbox (29d)","Jul Min Essential Coverage Checkbox (30a)","Jul Full-Time Employee Count (30b)","Jul Employee Count (30c)","Jul Aggregated Group Checkbox (30d)","Aug Min Essential Coverage Checkbox (31a)","Aug Full-Time Employee Count (31b)","Aug Employee Count (31c)","Aug Aggregated Group Checkbox (31d)","Sep Min Essential Coverage Checkbox (32a)","Sep Full-Time Employee Count (32b)","Sep Employee Count (32c)","Sep Aggregated Group Checkbox (32d)","Oct Min Essential Coverage Checkbox (33a)","Oct Full-Time Employee Count (33b)","Oct Employee Count (33c)","Oct Aggregated Group Checkbox (33d)","Nov Min Essential Coverage Checkbox (34a)","Nov Full-Time Employee Count (34b)","Nov Employee Count (34c)","Nov Aggregated Group Checkbox (34d)","Dec Min Essential Coverage Checkbox (35a)","Dec Full-Time Employee Count (35b)","Dec Employee Count (35c)","Dec Aggregated Group Checkbox (35d)","Other ALE Member Name 1 (36)","Other ALE Member EIN (36)","Other ALE Member Name 1 (37)","Other ALE Member EIN (37)","Other ALE Member Name 1 (38)","Other ALE Member EIN (38)","Other ALE Member Name 1 (39)","Other ALE Member EIN (39)","Other ALE Member Name 1 (40)","Other ALE Member EIN (40)","Other ALE Member Name 1 (41)","Other ALE Member EIN (41)","Other ALE Member Name 1 (42)","Other ALE Member EIN (42)","Other ALE Member Name 1 (43)","Other ALE Member EIN (43)","Other ALE Member Name 1 (44)","Other ALE Member EIN (44)","Other ALE Member Name 1 (45)","Other ALE Member EIN (45)","Other ALE Member Name 1 (46)","Other ALE Member EIN (46)","Other ALE Member Name 1 (47)","Other ALE Member EIN (47)","Other ALE Member Name 1 (48)","Other ALE Member EIN (48)","Other ALE Member Name 1 (49)","Other ALE Member EIN (49)","Other ALE Member Name 1 (50)","Other ALE Member EIN (50)","Other ALE Member Name 1 (51)","Other ALE Member EIN (51)","Other ALE Member Name 1 (52)","Other ALE Member EIN (52)","Other ALE Member Name 1 (53)","Other ALE Member EIN (53)","Other ALE Member Name 1 (54)","Other ALE Member EIN (54)","Other ALE Member Name 1 (55)","Other ALE Member EIN (55)","Other ALE Member Name 1 (56)","Other ALE Member EIN (56)","Other ALE Member Name 1 (57)","Other ALE Member EIN (57)","Other ALE Member Name 1 (58)","Other ALE Member EIN (58)","Other ALE Member Name 1 (59)","Other ALE Member EIN (59)","Other ALE Member Name 1 (60)","Other ALE Member EIN (60)","Other ALE Member Name 1 (61)","Other ALE Member EIN (61)","Other ALE Member Name 1 (62)","Other ALE Member EIN (62)","Other ALE Member Name 1 (63)","Other ALE Member EIN (63)","Other ALE Member Name 1 (64)","Other ALE Member EIN (64)","Other ALE Member Name 1 (65)","Other ALE Member EIN (65)"]
["Example Test Company",null,"123 Street",null,"Grand Rapids","MI","495011157",null,null,null,null,"Fred",null,"Dent",null,1112223333,4321,"111111112","Law","Office","211111112","555 Eastern St","Suite 123","Grand Rapids","MI","495017448",null,null,null,null,"Stan",null,"Mayor",null,"9155554568",null,"TRUE","5","TRUE","TRUE",null,"TRUE","5","5","TRUE",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Otherbusiness1","234564564","Otherbusiness2","234564564","Otherbusiness3","234564564","Otherbusiness4","234564564","Otherbusiness5","234564564","Otherbusiness6","234564564","Otherbusiness7","234564564","Otherbusiness8","234564564","Otherbusiness9","234564564","Otherbusiness10","234564564","Otherbusiness11","234564564","Otherbusiness12","234564564","Otherbusiness13","234564564","Otherbusiness14","234564564","Otherbusiness15","234564564","Otherbusiness16","234564564","Otherbusiness17","234564564","Otherbusiness18","234564564","Otherbusiness19","234564564","Otherbusiness20","234564564","Otherbusiness21","234564564","Otherbusines22","234564564","Otherbusiness23","234564564","Otherbusiness24","234564564","Otherbusiness25","234564564","Otherbusiness26","234564564","Otherbusiness27","234564564","Otherbusiness28","234564564","Otherbusiness29","234564564","Otherbusiness30","234564564"]
["Sample Import Company","Company Name Two","456 West Ave","Suite 400","Green Bay","WI",54301,null,null,null,null,"Jane",null,"Art",null,5554446666,null,"222222223",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"TRUE","6",null,null,null,null,null,null,null,"TRUE","6","6","FALSE","TRUE","6","6","FALSE","TRUE","6","6","FALSE","TRUE","6","6","FALSE","TRUE","6","6","FALSE","TRUE","6","6","FALSE","TRUE","6","6","FALSE","TRUE","6","6","FALSE","TRUE","6","6","FALSE","TRUE","6","6","FALSE","TRUE","6","6","FALSE","TRUE","6","6","FALSE"]

{"sheet":"Home","index":2,"n_rows":60,"n_cols":14,"rows_kept":60,"cut":false,"hidden":false,"merged":[[55,12,55,14],[1,5,2,8],[6,1,9,16],[10,2,10,4],[14,2,14,3],[14,5,14,7],[14,9,14,11],[14,13,14,15],[17,1,17,16],[19,1,19,16],[33,12,33,14]]}
[]
[null,true,null,null,null,"Version 5.5"]
[null,false]
[]
[]
[]
[null,"Importing Forms 1095-C & 1094-C Into Yearli\nA guide to formatting your data before importing it into Yearli."]
[]
[]
[]
[null,null,"Enter Template"]
[]
[]
[]
[null,null,"Home",null,null,"Template",null,null,null,"Help",null,null,null,"Field Name & Length"]
[]
[]
[]
[null,"Import Instructions"]
[null,"For the best results, we recommended using the provided Excel template to import your data into Yearli. You may use your own file, if desired, but your column headings must match the provided template to ensure proper mapping. "]
[]
[null,"Get Started Now With Data Validation (Recommended)"]
[]
[null," Follow these simple steps to prepare your data for import. Utilize data validation to ensure your data field names and length match IRS guidelines."]
[]
[null,null,"1. Verify the template you are using is the most current. "]
[]
[null,null,"2. Enable macros in template."]
[]
[null,null,"3. Gather your source data."]
[]
[null,null,"4. Match source data columns to template columns."]
[]
[null,null,"5. Enter data or copy all source data, excluding column headings, and paste into template. →",null,null,null,null,null,null,null,null,null,"View Template"]
[]
[null,null,"6. Verify cell \"B1\" in template states \"VALIDATION IS ON.\""]
[]
[null,null,"7. Click \"VALIDATE ALL NOW\" button located in cell \"C1\" of template. If an error is found the cell will turn yellow and provide a description of the error."]
[]
[null,null,"8. Correct errors, if found."]
[]
[null,null,"9. Save file and import into Yearli. Note: when saving the file, you will be asked if you would like to validate the entire file.  This is recommended."]
[]
[null,"Get Started Now Without Data Validation"]
[]
[null," Follow these simple steps to prepare your data for import without data validation."]
[]
[null,null,"1. Verify the template you are using is the most current. "]
[]
[null,null,"2. Disable macros in template - cell \"B1\" in template will indicate \"VALIDATION IS OFF.\""]
[]
[null,null,"3. Gather your source data."]
[]
[null,null,"4. Match source data columns to template columns."]
[]
[null,null,"5. Enter data or copy all source data, excluding column headings, and paste into template. →",null,null,null,null,null,null,null,null,null,"View Template"]
[]
[null,null,"6. Save file and import into Yearli."]
[]
[null,"* The 1094-C template is optional. "]

{"sheet":"Help","index":3,"n_rows":46,"n_cols":14,"rows_kept":46,"cut":false,"hidden":false,"merged":[[14,9,14,11],[14,13,14,15],[38,2,38,4],[1,5,2,8],[6,1,10,16],[14,2,14,3],[14,5,14,7],[29,2,29,16],[30,2,30,16],[31,2,31,16],[45,2,45,5],[17,1,17,16],[33,1,34,16],[41,1,41,16],[36,2,36,8],[18,1,18,16],[38,6,38,9],[38,11,38,13]]}
[]
[null,null,null,null,null,"Version 5.5"]
[]
[]
[]
[]
[null,"Help\nUnderstanding all of the rules associated with the Affordable Care Act can be confusing, but we're here to help. Greatland has full-time experts dedicated to understanding ACA reporting compliance. \n"]
[]
[]
[]
[]
[]
[]
[]
[null,null,"Home",null,null,"Template",null,null,null,"Help",null,null,null,"Field Name & Length"]
[]
[]
[]
[null,"Answers to Frequently Asked Questions:"]
[null,"•","Column headings in red are required to successfully import data"]
[null,"•","Delete sample data before entering your data into the import template"]
[null,"•","If enrolled in coverage, be sure to list the employee/responsible individual as a covered individual"]
[null,"•","For checkboxes, enter a value of True, 1, or X to check the box. To leave the box blank, enter a value of 0, False, or leave it blank."]
[null,"•","Use only the All 12 Months field or the individual Month fields, not both."]
[null,"•","Dates should be formatted as the Text cell format type not as the Date cell format type"]
[null,"•","SSNs and EINs can be entered with or without the hyphen"]
[null,"•","The 1094 Contact information is the company contact for the IRS; the 1095 Contact information is the company contact for the employee"]
[null,"•","The Reprint Reason column applies to Yearli Desktop and Premier only"]
[null,"•","The 1094-C tab is optional."]
[null,"•","The Online Retrieval System will use the field \"Employee Email (Online Retrieval)\" to send an email to your recipients providing secure and immediate online access to their tax form."]
[null,"•","If using a foreign country code, use the IRS foreign address codes found here:"]
[null,null," IRS Foreign Country Codes"]
[null,"Additional Support"]
[null,"Keeping up with the rules, regulations and many confusing details surrounding ACA filing can be difficult. Don't worry; our team of experts are here to help guide you through the filing process, with instant answers to your difficult questions."]
[]
[]
[null,null,"Support Hours: Monday - Friday | 9:00 am - 6:00 pm ET"]
[]
[null,null,"Phone: 877.789.1946",null,null,null,"Chat Now - Performance Users",null,null,null,null," Chat Now - Premier Users"]
[]
[null,"Search Our Knowledge Base"]
[null,"The Yearli knowledge base is your direct line to product experts, developers and quality assurance analysts, and is full of useful information. With an easy-to-use search, you'll find answers to commonly asked questions. So go ahead, search our FAQs, read through the articles, or get step-by-step instructions."]
[]
[null,"Available: 24 hours a day - 7 days a week - 365 days a year."]
[]
[null,null,"Search The Knowledge Base"]

{"sheet":"1095C Field Name & Length","index":4,"n_rows":133,"n_cols":15,"rows_kept":133,"cut":false,"hidden":false,"merged":[[130,3,130,8],[130,11,130,13],[131,3,131,8],[131,9,131,10],[131,11,131,13],[132,3,132,8],[132,11,132,13],[127,3,127,8],[127,11,127,13],[128,3,128,8],[128,11,128,13],[129,3,129,8],[129,11,129,13],[124,3,124,8],[124,11,124,13],[125,3,125,8],[125,11,125,13],[126,3,126,8],[126,11,126,13],[121,3,121,8],[121,11,121,13],[122,3,122,8],[122,11,122,13],[123,3,123,8],[123,11,123,13],[118,3,118,8],[118,11,118,13],[119,3,119,8],[119,11,119,13],[120,3,120,8],[120,11,120,13],[115,3,115,8],[115,11,115,13],[116,3,116,8],[116,11,116,13],[117,3,117,8],[117,11,117,13],[111,11,111,13],[112,3,112,8],[112,11,112,13],[113,3,113,8],[113,11,113,13],[114,3,114,8],[114,11,114,13],[106,3,106,8],[107,3,107,8],[108,3,108,8],[109,3,109,8],[110,3,110,8],[111,3,111,8],[100,3,100,8],[101,3,101,8],[102,3,102,8],[103,3,103,8],[104,3,104,8],[105,3,105,8],[96,3,96,8],[96,11,96,13],[97,3,97,8],[97,11,97,13],[98,3,98,8],[99,3,99,8],[93,3,93,8],[93,11,93,13],[94,3,94,8],[94,11,94,13],[95,3,95,8],[95,11,95,13],[90,3,90,8],[90,11,90,13],[91,3,91,8],[91,11,91,13],[92,3,92,8],[92,11,92,13],[87,3,87,8],[87,11,87,13],[88,3,88,8],[88,11,88,13],[89,3,89,8],[89,11,89,13],[84,3,84,8],[84,11,84,13],[85,3,85,8],[85,11,85,13],[86,3,86,8],[86,11,86,13],[81,3,81,8],[81,11,81,13],[82,3,82,8],[82,11,82,13],[83,3,83,8],[83,11,83,13],[78,3,78,8],[78,11,78,13],[79,3,79,8],[79,11,79,13],[80,3,80,8],[80,11,80,13],[75,3,75,8],[75,11,75,13],[76,3,76,8],[76,11,76,13],[77,3,77,8],[77,11,77,13],[72,3,72,8],[72,11,72,13],[73,3,73,8],[73,11,73,13],[74,3,74,8],[74,11,74,13],[69,3,69,8],[69,11,69,13],[70,3,70,8],[70,11,70,13],[71,3,71,8],[71,11,71,13],[66,3,66,8],[66,11,66,13],[67,3,67,8],[67,11,67,13],[68,3,68,8],[68,11,68,13],[63,3,63,8],[63,11,63,13],[64,3,64,8],[64,11,64,13],[65,3,65,8],[65,11,65,13],[60,3,60,8],[60,11,60,13],[61,3,61,8],[61,11,61,13],[62,3,62,8],[62,11,62,13],[57,3,57,8],[57,11,57,13],[58,3,58,8],[58,11,58,13],[59,3,59,8],[59,11,59,13],[54,3,54,8],[54,11,54,13],[55,3,55,8],[55,11,55,13],[56,3,56,8],[56,11,56,13],[51,3,51,8],[51,11,51,13],[52,3,52,8],[52,11,52,13],[53,3,53,8],[53,11,53,13],[48,3,48,8],[48,11,48,13],[49,3,49,8],[49,11,49,13],[50,3,50,8],[50,11,50,13],[45,3,45,8],[45,11,45,13],[46,3,46,8],[46,11,46,13],[47,3,47,8],[47,11,47,13],[42,3,42,8],[42,11,42,13],[43,3,43,8],[43,11,43,13],[44,3,44,8],[44,11,44,13],[39,3,39,8],[39,11,39,13],[40,3,40,8],[40,11,40,13],[41,3,41,8],[41,11,41,13],[36,3,36,8],[36,11,36,13],[37,3,37,8],[37,11,37,13],[38,3,38,8],[38,11,38,13],[33,3,33,8],[33,11,33,13],[34,3,34,8],[34,11,34,13],[35,3,35,8],[35,11,35,13],[30,3,30,8],[30,11,30,13],[31,3,31,8],[31,11,31,13],[32,3,32,8],[32,11,32,13],[27,3,27,8],[27,11,27,13],[28,3,28,8],[28,11,28,13],[29,3,29,8],[29,11,29,13],[24,3,24,8],[24,11,24,13],[25,3,25,8],[25,11,25,13],[26,3,26,8],[26,11,26,13],[23,3,23,8],[23,11,23,13],[18,3,18,8],[18,9,18,10],[18,11,18,13],[19,3,19,8],[19,11,19,13],[20,3,20,8],[20,11,20,13],[1,5,2,8],[6,1,10,16],[14,2,14,3],[14,5,14,7],[14,9,14,11],[14,13,14,15],[21,3,21,8],[21,11,21,13],[22,3,22,8],[22,11,22,13]]}
[]
[null,null,null,null,null,"Version 5.5"]
[]
[]
[]
[]
[null,"1095-C Field Name & Length"]
[]
[]
[]
[]
[]
[]
[]
[null,null,"Home",null,null,"Template",null,null,null,"Help",null,null,null,"Field Name & Length"]
[]
[]
[]
[null,null,null,"Field Name",null,null,null,null,null,"Maximum Length",null,"Characters Allowed",null,null,"Format"]
[null,null,null,"Name of Employer 1 (Box 7)","Name of Employer 1 (Box 7)","Name of Employer 1 (Box 7)","Name of Employer 1 (Box 7)","Name of Employer 1 (Box 7)","Name of Employer 1 (Box 7)",40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Name of Employer 2 (Box 7)","Name of Employer 2 (Box 7)","Name of Employer 2 (Box 7)","Name of Employer 2 (Box 7)","Name of Employer 2 (Box 7)","Name of Employer 2 (Box 7)",40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Employer Address 1 (Box 9)","Employer Address 1 (Box 9)","Employer Address 1 (Box 9)","Employer Address 1 (Box 9)","Employer Address 1 (Box 9)","Employer Address 1 (Box 9)",40,null,"A-Z, a-z, 0-9, hyphen, and forward slash"]
[null,null,null,"Employer Address 2 (Box 9)","Employer Address 2 (Box 9)","Employer Address 2 (Box 9)","Employer Address 2 (Box 9)","Employer Address 2 (Box 9)","Employer Address 2 (Box 9)",40,null,"A-Z, a-z, 0-9, hyphen, and forward slash"]
[null,null,null,"Employer City (Box 11)","Employer City (Box 11)","Employer City (Box 11)","Employer City (Box 11)","Employer City (Box 11)","Employer City (Box 11)",20,null,"A-Z and a-z"]
[null,null,null,"Employer State  (Box 12)","Employer State  (Box 12)","Employer State  (Box 12)","Employer State  (Box 12)","Employer State  (Box 12)","Employer State  (Box 12)",2,null,"State",null,null,"WI"]
[null,null,null,"Employer Zip (Box 13)","Employer Zip (Box 13)","Employer Zip (Box 13)","Employer Zip (Box 13)","Employer Zip (Box 13)","Employer Zip (Box 13)","5 or 9",null,"Numbers",null,null,"99999 or 999999999"]
[null,null,null,"Employer Foreign Address Indicator","Employer Foreign Address Indicator","Employer Foreign Address Indicator","Employer Foreign Address Indicator","Employer Foreign Address Indicator","Employer Foreign Address Indicator",5,null,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Employer Foreign State Name (Box 12)","Employer Foreign State Name (Box 12)","Employer Foreign State Name (Box 12)","Employer Foreign State Name (Box 12)","Employer Foreign State Name (Box 12)","Employer Foreign State Name (Box 12)",23,null,"A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe"]
[null,null,null,"Employer Foreign Postal Code (Box 13)","Employer Foreign Postal Code (Box 13)","Employer Foreign Postal Code (Box 13)","Employer Foreign Postal Code (Box 13)","Employer Foreign Postal Code (Box 13)","Employer Foreign Postal Code (Box 13)",15,null,"A-Z, a-z, 0-9, period, slash, and hyphen"]
[null,null,null,"Employer Foreign Country Code (Box 13)","Employer Country Code (Box 13)","Employer Country Code (Box 13)","Employer Country Code (Box 13)","Employer Country Code (Box 13)","Employer Country Code (Box 13)",2,null,"Foreign Country Codes List"]
[null,null,null,"1094 Contact First Name","1094 Contact First Name","1094 Contact First Name","1094 Contact First Name","1094 Contact First Name","1094 Contact First Name",25,null,"A-Z, a-z, and hyphen"]
[null,null,null,"1094 Contact Middle Initial","1094 Contact Middle Initial","1094 Contact Middle Initial","1094 Contact Middle Initial","1094 Contact Middle Initial","1094 Contact Middle Initial",1,null,"A-Z, a-z, and hyphen"]
[null,null,null,"1094 Contact Last Name","1094 Contact Last Name","1094 Contact Last Name","1094 Contact Last Name","1094 Contact Last Name","1094 Contact Last Name",25,null,"A-Z, a-z, and hyphen"]
[null,null,null,"1094 Contact Suffix","1094 Contact Suffix","1094 Contact Suffix","1094 Contact Suffix","1094 Contact Suffix","1094 Contact Suffix",4,null,"A-Z, a-z, and hyphen"]
[null,null,null,"1095 Contact Phone (Box 10)","1095 Contact Phone (Box 10)","1095 Contact Phone (Box 10)","1095 Contact Phone (Box 10)","1095 Contact Phone (Box 10)","1095 Contact Phone (Box 10)",15,null,"Numbers"]
[null,null,null,"1095 Contact Phone Ext (Box 10)","1095 Contact Phone Ext (Box 10)","1095 Contact Phone Ext (Box 10)","1095 Contact Phone Ext (Box 10)","1095 Contact Phone Ext (Box 10)","1095 Contact Phone Ext (Box 10)",5,null,"Numbers"]
[null,null,null,"1094 Contact Phone","1094 Contact Phone","1094 Contact Phone","1094 Contact Phone","1094 Contact Phone","1094 Contact Phone",15,null,"Numbers"]
[null,null,null,"1094 Contact Phone Ext","1094 Contact Phone Ext","1094 Contact Phone Ext","1094 Contact Phone Ext","1094 Contact Phone Ext","1094 Contact Phone Ext",5,null,"Numbers"]
[null,null,null,"Employer Identification Number (Box 8)","Employer Identification Number (Box 8)","Employer Identification Number (Box 8)","Employer Identification Number (Box 8)","Employer Identification Number (Box 8)","Employer Identification Number (Box 8)",9,null,"Numbers",null,null,999999999]
[null,null,null,"Employer Misc Search One","Employer Misc Search One","Employer Misc Search One","Employer Misc Search One","Employer Misc Search One","Employer Misc Search One",40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Employer Misc Search Two","Employer Misc Search Two","Employer Misc Search Two","Employer Misc Search Two","Employer Misc Search Two","Employer Misc Search Two",40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Employee Social Security Number (Box 2)","Employee Social Security Number (Box 2)","Employee Social Security Number (Box 2)","Employee Social Security Number (Box 2)","Employee Social Security Number (Box 2)","Employee Social Security Number (Box 2)",9,null,"Numbers",null,null,999999999]
[null,null,null,"Employee First Name (Box 1)","Employee First Name (Box 1)","Employee First Name (Box 1)","Employee First Name (Box 1)","Employee First Name (Box 1)","Employee First Name (Box 1)",15,null,"A-Z, a-z, and hyphen",null,null," "]
[null,null,null,"Employee Middle Initial (Box 1)","Employee Middle Initial (Box 1)","Employee Middle Initial (Box 1)","Employee Middle Initial (Box 1)","Employee Middle Initial (Box 1)","Employee Middle Initial (Box 1)",1,null,"A-Z, a-z, and hyphen",null,null," "]
[null,null,null,"Employee Last Name (Box 1)","Employee Last Name (Box 1)","Employee Last Name (Box 1)","Employee Last Name (Box 1)","Employee Last Name (Box 1)","Employee Last Name (Box 1)",20,null,"A-Z, a-z, and hyphen",null,null," "]
[null,null,null,"Employee Suffix (Box 1)","Employee Suffix (Box 1)","Employee Suffix (Box 1)","Employee Suffix (Box 1)","Employee Suffix (Box 1)","Employee Suffix (Box 1)",4,null,"A-Z, a-z, and hyphen",null,null," "]
[null,null,null,"Employee Address 1 (Box 3)","Employee Address 1 (Box 3)","Employee Address 1 (Box 3)","Employee Address 1 (Box 3)","Employee Address 1 (Box 3)","Employee Address 1 (Box 3)",40,null,"A-Z, a-z, 0-9, hyphen, and forward slash",null,null," "]
[null,null,null,"Employee Address 2 (Box 3)","Employee Address 2 (Box 3)","Employee Address 2 (Box 3)","Employee Address 2 (Box 3)","Employee Address 2 (Box 3)","Employee Address 2 (Box 3)",40,null,"A-Z, a-z, 0-9, hyphen, and forward slash",null,null," "]
[null,null,null,"Employee City (Box 4)","Employee City (Box 4)","Employee City (Box 4)","Employee City (Box 4)","Employee City (Box 4)","Employee City (Box 4)",20,null,"A-Z and a-z",null,null," "]
[null,null,null,"Employee State (Box 5)","Employee State (Box 5)","Employee State (Box 5)","Employee State (Box 5)","Employee State (Box 5)","Employee State (Box 5)",2,null,"State",null,null,"WI"]
[null,null,null,"Employee Zip (Box 6)","Employee Zip (Box 6)","Employee Zip (Box 6)","Employee Zip (Box 6)","Employee Zip (Box 6)","Employee Zip (Box 6)","5 or 9",null,"Numbers",null,null,"99999 or 999999999"]
[null,null,null,"Employee Foreign Address Indicator","Employee Foreign Address Indicator","Employee Foreign Address Indicator","Employee Foreign Address Indicator","Employee Foreign Address Indicator","Employee Foreign Address Indicator",5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Employee Foreign State Name (Box 5)","Employee Foreign State Name (Box 5)","Employee Foreign State Name (Box 5)","Employee Foreign State Name (Box 5)","Employee Foreign State Name (Box 5)","Employee Foreign State Name (Box 5)",23,null,"A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe"]
[null,null,null,"Employee Foreign Postal Code (Box 6)","Employee Foreign Postal Code (Box 6)","Employee Foreign Postal Code (Box 6)","Employee Foreign Postal Code (Box 6)","Employee Foreign Postal Code (Box 6)","Employee Foreign Postal Code (Box 6)",15,null,"A-Z, a-z, 0-9, period, slash, and hyphen"]
[null,null,null,"Employee Foreign Country Code (Box 6)","Employee Country Code (Box 6)","Employee Country Code (Box 6)","Employee Country Code (Box 6)","Employee Country Code (Box 6)","Employee Country Code (Box 6)",2,null,"Foreign Country Codes List"]
[null,null,null,"Employee Email (Online Retrieval)","Employee Email","Employee Email","Employee Email","Employee Email","Employee Email",75,null,"A-Z, a-z, 0-9, !, #, $, %, &, ', *, +, /, =, ?, ^, _ , `, {, |, }, ~,-, ., and @",null,null,"Required for Online Retrieval"]
[null,null,null,"Employee Misc Search","Employee Misc Search","Employee Misc Search","Employee Misc Search","Employee Misc Search","Employee Misc Search",40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Employee Age",null,null,null,null,null,3,null,"Numbers"]
[null,null,null,"Plan Start Month","Plan Start Month","Plan Start Month","Plan Start Month","Plan Start Month","Plan Start Month",2,null,"Plan Start Month",null,null,"00, 01, 02, 03, 04, 05, 06, 07, 08, 09, 10, 11, or 12"]
[null,null,null,"All 12 Month Offer Of Coverage (Line 14)","All 12 Month Offer Of Coverage (Line 14)","All 12 Month Offer Of Coverage (Line 14)","All 12 Month Offer Of Coverage (Line 14)","All 12 Month Offer Of Coverage (Line 14)","All 12 Month Offer Of Coverage (Line 14)",2,null,"Offer of Coverage",null,null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
[null,null,null,"Jan Offer Of Coverage (Line 14)","Jan Offer Of Coverage (Line 14)","Jan Offer Of Coverage (Line 14)","Jan Offer Of Coverage (Line 14)","Jan Offer Of Coverage (Line 14)","Jan Offer Of Coverage (Line 14)",2,null,"Offer of Coverage",null,null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
[null,null,null,"Feb Offer Of Coverage (Line 14)","Feb Offer Of Coverage (Line 14)","Feb Offer Of Coverage (Line 14)","Feb Offer Of Coverage (Line 14)","Feb Offer Of Coverage (Line 14)","Feb Offer Of Coverage (Line 14)",2,null,"Offer of Coverage",null,null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
[null,null,null,"Mar Offer Of Coverage (Line 14)","Mar Offer Of Coverage (Line 14)","Mar Offer Of Coverage (Line 14)","Mar Offer Of Coverage (Line 14)","Mar Offer Of Coverage (Line 14)","Mar Offer Of Coverage (Line 14)",2,null,"Offer of Coverage",null,null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
[null,null,null,"Apr Offer Of Coverage (Line 14)","Apr Offer Of Coverage (Line 14)","Apr Offer Of Coverage (Line 14)","Apr Offer Of Coverage (Line 14)","Apr Offer Of Coverage (Line 14)","Apr Offer Of Coverage (Line 14)",2,null,"Offer of Coverage",null,null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
[null,null,null,"May Offer Of Coverage (Line 14)","May Offer Of Coverage (Line 14)","May Offer Of Coverage (Line 14)","May Offer Of Coverage (Line 14)","May Offer Of Coverage (Line 14)","May Offer Of Coverage (Line 14)",2,null,"Offer of Coverage",null,null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
[null,null,null,"Jun Offer Of Coverage (Line 14)","Jun Offer Of Coverage (Line 14)","Jun Offer Of Coverage (Line 14)","Jun Offer Of Coverage (Line 14)","Jun Offer Of Coverage (Line 14)","Jun Offer Of Coverage (Line 14)",2,null,"Offer of Coverage",null,null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
[null,null,null,"Jul Offer Of Coverage (Line 14)","Jul Offer Of Coverage (Line 14)","Jul Offer Of Coverage (Line 14)","Jul Offer Of Coverage (Line 14)","Jul Offer Of Coverage (Line 14)","Jul Offer Of Coverage (Line 14)",2,null,"Offer of Coverage",null,null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
[null,null,null,"Aug Offer Of Coverage (Line 14)","Aug Offer Of Coverage (Line 14)","Aug Offer Of Coverage (Line 14)","Aug Offer Of Coverage (Line 14)","Aug Offer Of Coverage (Line 14)","Aug Offer Of Coverage (Line 14)",2,null,"Offer of Coverage",null,null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
[null,null,null,"Sep Offer Of Coverage (Line 14)","Sep Offer Of Coverage (Line 14)","Sep Offer Of Coverage (Line 14)","Sep Offer Of Coverage (Line 14)","Sep Offer Of Coverage (Line 14)","Sep Offer Of Coverage (Line 14)",2,null,"Offer of Coverage",null,null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
[null,null,null,"Oct Offer Of Coverage (Line 14)","Oct Offer Of Coverage (Line 14)","Oct Offer Of Coverage (Line 14)","Oct Offer Of Coverage (Line 14)","Oct Offer Of Coverage (Line 14)","Oct Offer Of Coverage (Line 14)",2,null,"Offer of Coverage",null,null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
[null,null,null,"Nov Offer Of Coverage (Line 14)","Nov Offer Of Coverage (Line 14)","Nov Offer Of Coverage (Line 14)","Nov Offer Of Coverage (Line 14)","Nov Offer Of Coverage (Line 14)","Nov Offer Of Coverage (Line 14)",2,null,"Offer of Coverage",null,null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
[null,null,null,"Dec Offer Of Coverage (Line 14)","Dec Offer Of Coverage (Line 14)","Dec Offer Of Coverage (Line 14)","Dec Offer Of Coverage (Line 14)","Dec Offer Of Coverage (Line 14)","Dec Offer Of Coverage (Line 14)",2,null,"Offer of Coverage",null,null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
[null,null,null,"Employee Required Contribution For All 12 Months (Line 15)","Employee Required Contribution For All 12 Months (Line 15)","Employee Required Contribution For All 12 Months (Line 15)","Employee Required Contribution For All 12 Months (Line 15)","Employee Required Contribution For All 12 Months (Line 15)","Employee Required Contribution For All 12 Months (Line 15)",7,null,"Numbers and decimal",null,null,9999.99]
[null,null,null,"Employee Required Contribution For Jan (Line 15)","Employee Required Contribution For Jan (Line 15)","Employee Required Contribution For Jan (Line 15)","Employee Required Contribution For Jan (Line 15)","Employee Required Contribution For Jan (Line 15)","Employee Required Contribution For Jan (Line 15)",7,null,"Numbers and decimal",null,null,9999.99]
[null,null,null,"Employee Required Contribution For Feb (Line 15)","Employee Required Contribution For Feb (Line 15)","Employee Required Contribution For Feb (Line 15)","Employee Required Contribution For Feb (Line 15)","Employee Required Contribution For Feb (Line 15)","Employee Required Contribution For Feb (Line 15)",7,null,"Numbers and decimal",null,null,9999.99]
[null,null,null,"Employee Required Contribution For Mar (Line 15)","Employee Required Contribution For Mar (Line 15)","Employee Required Contribution For Mar (Line 15)","Employee Required Contribution For Mar (Line 15)","Employee Required Contribution For Mar (Line 15)","Employee Required Contribution For Mar (Line 15)",7,null,"Numbers and decimal",null,null,9999.99]
[null,null,null,"Employee Required Contribution For Apr (Line 15)","Employee Required Contribution For Apr (Line 15)","Employee Required Contribution For Apr (Line 15)","Employee Required Contribution For Apr (Line 15)","Employee Required Contribution For Apr (Line 15)","Employee Required Contribution For Apr (Line 15)",7,null,"Numbers and decimal",null,null,9999.99]
[null,null,null,"Employee Required Contribution For May (Line 15)","Employee Required Contribution For May (Line 15)","Employee Required Contribution For May (Line 15)","Employee Required Contribution For May (Line 15)","Employee Required Contribution For May (Line 15)","Employee Required Contribution For May (Line 15)",7,null,"Numbers and decimal",null,null,9999.99]
[null,null,null,"Employee Required Contribution For Jun (Line 15)","Employee Required Contribution For Jun (Line 15)","Employee Required Contribution For Jun (Line 15)","Employee Required Contribution For Jun (Line 15)","Employee Required Contribution For Jun (Line 15)","Employee Required Contribution For Jun (Line 15)",7,null,"Numbers and decimal",null,null,9999.99]
[null,null,null,"Employee Required Contribution For Jul (Line 15)","Employee Required Contribution For Jul (Line 15)","Employee Required Contribution For Jul (Line 15)","Employee Required Contribution For Jul (Line 15)","Employee Required Contribution For Jul (Line 15)","Employee Required Contribution For Jul (Line 15)",7,null,"Numbers and decimal",null,null,9999.99]
[null,null,null,"Employee Required Contribution For Aug (Line 15)","Employee Required Contribution For Aug (Line 15)","Employee Required Contribution For Aug (Line 15)","Employee Required Contribution For Aug (Line 15)","Employee Required Contribution For Aug (Line 15)","Employee Required Contribution For Aug (Line 15)",7,null,"Numbers and decimal",null,null,9999.99]
[null,null,null,"Employee Required Contribution For Sep (Line 15)","Employee Required Contribution For Sep (Line 15)","Employee Required Contribution For Sep (Line 15)","Employee Required Contribution For Sep (Line 15)","Employee Required Contribution For Sep (Line 15)","Employee Required Contribution For Sep (Line 15)",7,null,"Numbers and decimal",null,null,9999.99]
[null,null,null,"Employee Required Contribution For Oct (Line 15)","Employee Required Contribution For Oct (Line 15)","Employee Required Contribution For Oct (Line 15)","Employee Required Contribution For Oct (Line 15)","Employee Required Contribution For Oct (Line 15)","Employee Required Contribution For Oct (Line 15)",7,null,"Numbers and decimal",null,null,9999.99]
[null,null,null,"Employee Required Contribution For Nov (Line 15)","Employee Required Contribution For Nov (Line 15)","Employee Required Contribution For Nov (Line 15)","Employee Required Contribution For Nov (Line 15)","Employee Required Contribution For Nov (Line 15)","Employee Required Contribution For Nov (Line 15)",7,null,"Numbers and decimal",null,null,9999.99]
[null,null,null,"Employee Required Contribution For Dec (Line 15)","Employee Required Contribution For Dec (Line 15)","Employee Required Contribution For Dec (Line 15)","Employee Required Contribution For Dec (Line 15)","Employee Required Contribution For Dec (Line 15)","Employee Required Contribution For Dec (Line 15)",7,null,"Numbers and decimal",null,null,9999.99]
[null,null,null,"Safe Harbor And Other Relief For All 12 Months (Line 16)","Safe Harbor And Other Relief For All 12 Months (Line 16)","Safe Harbor And Other Relief For All 12 Months (Line 16)","Safe Harbor And Other Relief For All 12 Months (Line 16)","Safe Harbor And Other Relief For All 12 Months (Line 16)","Safe Harbor And Other Relief For All 12 Months (Line 16)",2,null,"Safe Harbor",null,null,"2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
[null,null,null,"Safe Harbor And Other Relief For Jan (Line 16)","Safe Harbor And Other Relief For Jan (Line 16)","Safe Harbor And Other Relief For Jan (Line 16)","Safe Harbor And Other Relief For Jan (Line 16)","Safe Harbor And Other Relief For Jan (Line 16)","Safe Harbor And Other Relief For Jan (Line 16)",2,null,"Safe Harbor",null,null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
[null,null,null,"Safe Harbor And Other Relief For Feb (Line 16)","Safe Harbor And Other Relief For Feb (Line 16)","Safe Harbor And Other Relief For Feb (Line 16)","Safe Harbor And Other Relief For Feb (Line 16)","Safe Harbor And Other Relief For Feb (Line 16)","Safe Harbor And Other Relief For Feb (Line 16)",2,null,"Safe Harbor",null,null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
[null,null,null,"Safe Harbor And Other Relief For Mar (Line 16)","Safe Harbor And Other Relief For Mar (Line 16)","Safe Harbor And Other Relief For Mar (Line 16)","Safe Harbor And Other Relief For Mar (Line 16)","Safe Harbor And Other Relief For Mar (Line 16)","Safe Harbor And Other Relief For Mar (Line 16)",2,null,"Safe Harbor",null,null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
[null,null,null,"Safe Harbor And Other Relief For Apr (Line 16)","Safe Harbor And Other Relief For Apr (Line 16)","Safe Harbor And Other Relief For Apr (Line 16)","Safe Harbor And Other Relief For Apr (Line 16)","Safe Harbor And Other Relief For Apr (Line 16)","Safe Harbor And Other Relief For Apr (Line 16)",2,null,"Safe Harbor",null,null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
[null,null,null,"Safe Harbor And Other Relief For May (Line 16)","Safe Harbor And Other Relief For May (Line 16)","Safe Harbor And Other Relief For May (Line 16)","Safe Harbor And Other Relief For May (Line 16)","Safe Harbor And Other Relief For May (Line 16)","Safe Harbor And Other Relief For May (Line 16)",2,null,"Safe Harbor",null,null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
[null,null,null,"Safe Harbor And Other Relief For Jun (Line 16)","Safe Harbor And Other Relief For Jun (Line 16)","Safe Harbor And Other Relief For Jun (Line 16)","Safe Harbor And Other Relief For Jun (Line 16)","Safe Harbor And Other Relief For Jun (Line 16)","Safe Harbor And Other Relief For Jun (Line 16)",2,null,"Safe Harbor",null,null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
[null,null,null,"Safe Harbor And Other Relief For Jul (Line 16)","Safe Harbor And Other Relief For Jul (Line 16)","Safe Harbor And Other Relief For Jul (Line 16)","Safe Harbor And Other Relief For Jul (Line 16)","Safe Harbor And Other Relief For Jul (Line 16)","Safe Harbor And Other Relief For Jul (Line 16)",2,null,"Safe Harbor",null,null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
[null,null,null,"Safe Harbor And Other Relief For Aug (Line 16)","Safe Harbor And Other Relief For Aug (Line 16)","Safe Harbor And Other Relief For Aug (Line 16)","Safe Harbor And Other Relief For Aug (Line 16)","Safe Harbor And Other Relief For Aug (Line 16)","Safe Harbor And Other Relief For Aug (Line 16)",2,null,"Safe Harbor",null,null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
[null,null,null,"Safe Harbor And Other Relief For Sep (Line 16)","Safe Harbor And Other Relief For Sep (Line 16)","Safe Harbor And Other Relief For Sep (Line 16)","Safe Harbor And Other Relief For Sep (Line 16)","Safe Harbor And Other Relief For Sep (Line 16)","Safe Harbor And Other Relief For Sep (Line 16)",2,null,"Safe Harbor",null,null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
[null,null,null,"Safe Harbor And Other Relief For Oct (Line 16)","Safe Harbor And Other Relief For Oct (Line 16)","Safe Harbor And Other Relief For Oct (Line 16)","Safe Harbor And Other Relief For Oct (Line 16)","Safe Harbor And Other Relief For Oct (Line 16)","Safe Harbor And Other Relief For Oct (Line 16)",2,null,"Safe Harbor",null,null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
[null,null,null,"Safe Harbor And Other Relief For Nov (Line 16)","Safe Harbor And Other Relief For Nov (Line 16)","Safe Harbor And Other Relief For Nov (Line 16)","Safe Harbor And Other Relief For Nov (Line 16)","Safe Harbor And Other Relief For Nov (Line 16)","Safe Harbor And Other Relief For Nov (Line 16)",2,null,"Safe Harbor",null,null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
[null,null,null,"Safe Harbor And Other Relief For Dec (Line 16)","Safe Harbor And Other Relief For Dec (Line 16)","Safe Harbor And Other Relief For Dec (Line 16)","Safe Harbor And Other Relief For Dec (Line 16)","Safe Harbor And Other Relief For Dec (Line 16)","Safe Harbor And Other Relief For Dec (Line 16)",2,null,"Safe Harbor",null,null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
[null,null,null,"Zip Code For All 12 Months (Line 17)",null,null,null,null,null,5,null,null,"Numbers",null,99999]
[null,null,null,"Zip Code For Jan (Line 17)",null,null,null,null,null,5,null,null,"Numbers",null,99999]
[null,null,null,"Zip Code For Feb (Line 17)",null,null,null,null,null,5,null,null,"Numbers",null,99999]
[null,null,null,"Zip Code For Mar (Line 17)",null,null,null,null,null,5,null,null,"Numbers",null,99999]
[null,null,null,"Zip Code For Apr (Line 17)",null,null,null,null,null,5,null,null,"Numbers",null,99999]
[null,null,null,"Zip Code For May (Line 17)",null,null,null,null,null,5,null,null,"Numbers",null,99999]
[null,null,null,"Zip Code For Jun (Line 17)",null,null,null,null,null,5,null,null,"Numbers",null,99999]
[null,null,null,"Zip Code For Jul (Line 17)",null,null,null,null,null,5,null,null,"Numbers",null,99999]
[null,null,null,"Zip Code For Aug (Line 17)",null,null,null,null,null,5,null,null,"Numbers",null,99999]
[null,null,null,"Zip Code For Sep (Line 17)",null,null,null,null,null,5,null,null,"Numbers",null,99999]
[null,null,null,"Zip Code For Oct (Line 17)",null,null,null,null,null,5,null,null,"Numbers",null,99999]
[null,null,null,"Zip Code For Nov (Line 17)",null,null,null,null,null,5,null,null,"Numbers",null,99999]
[null,null,null,"Zip Code For Dec (Line 17)",null,null,null,null,null,5,null,null,"Numbers",null,99999]
[null,null,null,"Covered Individual Checkbox (Part III)","Covered Individual Checkbox (Part III)","Covered Individual Checkbox (Part III)","Covered Individual Checkbox (Part III)","Covered Individual Checkbox (Part III)","Covered Individual Checkbox (Part III)",5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)",null,null," "]
[null,null,null,"Individual SSN Or TIN (b1) Through Individual SSN Or TIN (b25)","Individual SSN Or TIN (b1) \nThrough\n Individual SSN Or TIN (b25)","Individual SSN Or TIN (b1) \nThrough\n Individual SSN Or TIN (b25)","Individual SSN Or TIN (b1) \nThrough\n Individual SSN Or TIN (b25)","Individual SSN Or TIN (b1) \nThrough\n Individual SSN Or TIN (b25)","Individual SSN Or TIN (b1) \nThrough\n Individual SSN Or TIN (b25)",9,null,"Numbers",null,null,999999999]
[null,null,null,"DOB (c1) Through DOB (c25)","DOB (c1)\nThrough \nDOB (c25)","DOB (c1)\nThrough \nDOB (c25)","DOB (c1)\nThrough \nDOB (c25)","DOB (c1)\nThrough \nDOB (c25)","DOB (c1)\nThrough \nDOB (c25)",10,null,"Numbers and slashes",null,null,"99/99/9999"]
[null,null,null,"First Name (a1) Through First Name (a25)","First Name (a1) \nThrough\nFirst Name (a25)","First Name (a1) \nThrough\nFirst Name (a25)","First Name (a1) \nThrough\nFirst Name (a25)","First Name (a1) \nThrough\nFirst Name (a25)","First Name (a1) \nThrough\nFirst Name (a25)",15,null,"A-Z, a-z, and hyphen"]
[null,null,null,"Middle Initial (a1) Through Middle Initial (a25)","Middle Initial (a1)\nThrough\nMiddle Initial (a25)","Middle Initial (a1)\nThrough\nMiddle Initial (a25)","Middle Initial (a1)\nThrough\nMiddle Initial (a25)","Middle Initial (a1)\nThrough\nMiddle Initial (a25)","Middle Initial (a1)\nThrough\nMiddle Initial (a25)",1,null,"A-Z, a-z, and hyphen"]
[null,null,null,"Last Name (a1) Through Last Name (a25)","Last Name (a1)\nThrough\nLast Name (a25)","Last Name (a1)\nThrough\nLast Name (a25)","Last Name (a1)\nThrough\nLast Name (a25)","Last Name (a1)\nThrough\nLast Name (a25)","Last Name (a1)\nThrough\nLast Name (a25)",20,null,"A-Z, a-z, and hyphen"]
[null,null,null,"Suffix (a1) Through Suffix (a25)","Suffix (a1)\nThrough\nSuffix (a25)","Suffix (a1)\nThrough\nSuffix (a25)","Suffix (a1)\nThrough\nSuffix (a25)","Suffix (a1)\nThrough\nSuffix (a25)","Suffix (a1)\nThrough\nSuffix (a25)",4,null,"A-Z, a-z, and hyphen"]
[null,null,null,"Covered 12 Months (d1) Through Covered 12 Months (d25)","Covered 12 Months (d1)\nThrough\nCovered 12 Months (d25)","Covered 12 Months (d1)\nThrough\nCovered 12 Months (d25)","Covered 12 Months (d1)\nThrough\nCovered 12 Months (d25)","Covered 12 Months (d1)\nThrough\nCovered 12 Months (d25)","Covered 12 Months (d1)\nThrough\nCovered 12 Months (d25)",5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)",null,null," "]
[null,null,null,"Jan (e1) Through Jan (e25)","Jan (e1)\nThrough\nJan (e25)","Jan (e1)\nThrough\nJan (e25)","Jan (e1)\nThrough\nJan (e25)","Jan (e1)\nThrough\nJan (e25)","Jan (e1)\nThrough\nJan (e25)",5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)",null,null," "]
[null,null,null,"Feb (e1) Through Feb (e25)","Feb (e1)\nThrough\nFeb (e25)","Feb (e1)\nThrough\nFeb (e25)","Feb (e1)\nThrough\nFeb (e25)","Feb (e1)\nThrough\nFeb (e25)","Feb (e1)\nThrough\nFeb (e25)",5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)",null,null," "]
[null,null,null,"Mar (e1) Through Mar (e25)","Mar (e1)\nThrough\nMar (e25)","Mar (e1)\nThrough\nMar (e25)","Mar (e1)\nThrough\nMar (e25)","Mar (e1)\nThrough\nMar (e25)","Mar (e1)\nThrough\nMar (e25)",5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)",null,null," "]
[null,null,null,"Apr (e1) Through Apr (e25)","Apr (e1)\nThrough\nApr (e25)","Apr (e1)\nThrough\nApr (e25)","Apr (e1)\nThrough\nApr (e25)","Apr (e1)\nThrough\nApr (e25)","Apr (e1)\nThrough\nApr (e25)",5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)",null,null," "]
[null,null,null,"May (e1) Through May (e25)","May (e1)\nThrough\nMay (e25)","May (e1)\nThrough\nMay (e25)","May (e1)\nThrough\nMay (e25)","May (e1)\nThrough\nMay (e25)","May (e1)\nThrough\nMay (e25)",5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)",null,null," "]
[null,null,null,"Jun (e1) Through Jun (e25)","Jun (e1)\nThrough\nJun (e25)","Jun (e1)\nThrough\nJun (e25)","Jun (e1)\nThrough\nJun (e25)","Jun (e1)\nThrough\nJun (e25)","Jun (e1)\nThrough\nJun (e25)",5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)",null,null," "]
[null,null,null,"Jul (e1) Through Jul (e25)","Jul (e1)\nThrough\nJul (e25)","Jul (e1)\nThrough\nJul (e25)","Jul (e1)\nThrough\nJul (e25)","Jul (e1)\nThrough\nJul (e25)","Jul (e1)\nThrough\nJul (e25)",5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)",null,null," "]
[null,null,null,"Aug (e1) Through Aug (e25)","Aug (e1)\nThrough\nAug (e25)","Aug (e1)\nThrough\nAug (e25)","Aug (e1)\nThrough\nAug (e25)","Aug (e1)\nThrough\nAug (e25)","Aug (e1)\nThrough\nAug (e25)",5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)",null,null," "]
[null,null,null,"Sep (e1) Through Sep (e25)","Sep (e1)\nThrough\nSep (e25)","Sep (e1)\nThrough\nSep (e25)","Sep (e1)\nThrough\nSep (e25)","Sep (e1)\nThrough\nSep (e25)","Sep (e1)\nThrough\nSep (e25)",5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)",null,null," "]
[null,null,null,"Oct (e1) Through Oct (e25)","Oct (e1)\nThrough\nOct (e25)","Oct (e1)\nThrough\nOct (e25)","Oct (e1)\nThrough\nOct (e25)","Oct (e1)\nThrough\nOct (e25)","Oct (e1)\nThrough\nOct (e25)",5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)",null,null," "]
[null,null,null,"Nov (e1) Through Nov (e25)","Nov (e1) Through Nov (e25)","Nov (e1) Through Nov (e25)","Nov (e1) Through Nov (e25)","Nov (e1) Through Nov (e25)","Nov (e1) Through Nov (e25)",5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)",null,null," "]
[null,null,null,"Dec (e1) Through Dec (e25)","Oct (e1) Through Oct (e25)","Oct (e1) Through Oct (e25)","Oct (e1) Through Oct (e25)","Oct (e1) Through Oct (e25)","Oct (e1) Through Oct (e25)",5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)",null,null," "]
[null,null,null,"Reprint Reason (R for reissued, C for corrected)","Dec (e1) Through Dec (e25)","Dec (e1) Through Dec (e25)","Dec (e1) Through Dec (e25)","Dec (e1) Through Dec (e25)","Dec (e1) Through Dec (e25)",9,null,"R, C, Reissued, Corrected"]
[null,null,null,"ACA State Filing","Oct (e1) Through Oct (e25)","Oct (e1) Through Oct (e25)","Oct (e1) Through Oct (e25)","Oct (e1) Through Oct (e25)","Oct (e1) Through Oct (e25)",8,null,"CA, DC, NJ, and/or RI",null,null," "]

{"sheet":"1094C Field Name & 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[]
[null,null,null,null,null,"Version 5.5"]
[]
[]
[]
[]
[null,"1094-C Field Name & Length"]
[]
[]
[]
[]
[]
[]
[]
[null,null,"Home",null,null,"Template",null,null,null,"Help",null,null,null,"Field Name & Length"]
[]
[]
[]
[null,null,null,"Field Name",null,null,null,null,null,"Maximum Length",null,"Characters Allowed",null,null,"Format"]
[null,null,null,"Name Of Employer 1 (Box 1)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Name Of Employer 2 (Box 1)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Employer Address 1 (Box 3)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hyphen, and forward slash"]
[null,null,null,"Employer Address 2 (Box 3)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hyphen, and forward slash"]
[null,null,null,"Employer City (Box 4)",null,null,null,null,null,20,null,"A-Z and a-z"]
[null,null,null,"Employer State (Box 5)",null,null,null,null,null,2,null,"State",null,null,"WI"]
[null,null,null,"Employer Zip (Box 6)",null,null,null,null,null,"5 or 9",null,"Numbers",null,null,"99999 or 999999999"]
[null,null,null,"Employer Foreign Address Indicator",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Employer Foreign State Name (Box 5)",null,null,null,null,null,23,null,"A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe"]
[null,null,null,"Employer Foreign Postal Code (Box 6)",null,null,null,null,null,15,null,"A-Z, a-z, 0-9, period, slash, and hyphen"]
[null,null,null,"Employer Foreign Country Code (Box 6)",null,null,null,null,null,2,null,"Foreign Country Codes List"]
[null,null,null,"1094 Contact First Name (Box 7)",null,null,null,null,null,25,null,"A-Z, a-z, and hyphen"]
[null,null,null,"1094 Contact Middle Initial (Box 7)",null,null,null,null,null,1,null,"A-Z, a-z, and hyphen"]
[null,null,null,"1094 Contact Last Name (Box 7)",null,null,null,null,null,25,null,"A-Z, a-z, and hyphen"]
[null,null,null,"1094 Contact Suffix (Box 7)",null,null,null,null,null,4,null,"A-Z, a-z, and hyphen"]
[null,null,null,"1094 Contact Phone (Box 8)",null,null,null,null,null,15,null,"Numbers"]
[null,null,null,"1094 Contact Phone Ext (Box 8)",null,null,null,null,null,5,null,"Numbers"]
[null,null,null,"Employer Identification Number (Box 2)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Govt Entity Name 1 (Box 9)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Govt Entity Name 2 (Box 9)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Govt Entity Employer Identification Number (Box 10)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Govt Entity Address 1 (Box 11)",null,null,null,null,null,35,null,"A-Z, a-z, 0-9, hyphen, and forward slash"]
[null,null,null,"Govt Entity Address 2 (Box 11)",null,null,null,null,null,35,null,"A-Z, a-z, 0-9, hyphen, and forward slash"]
[null,null,null,"Govt Entity City (Box 12)",null,null,null,null,null,20,null,"A-Z and a-z"]
[null,null,null,"Govt Entity State (Box 13)",null,null,null,null,null,2,null,"State",null,null,"WI"]
[null,null,null,"Govt Entity Zip (Box 14)",null,null,null,null,null,"5 or 9",null,"Numbers",null,null,"99999 or 999999999"]
[null,null,null,"Govt Entity Foreign Address Indicator",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Govt Entity Foreign State Name (Box 13)",null,null,null,null,null,23,null,"A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe"]
[null,null,null,"Govt Entity Foreign Postal Code (Box 14)",null,null,null,null,null,15,null,"A-Z, a-z, 0-9, period, slash, and hyphen"]
[null,null,null,"Govt Entity Foreign Country Code (Box 14)",null,null,null,null,null,2,null,"Foreign Country Codes List"]
[null,null,null,"Govt Entity Contact First Name (Box 15)",null,null,null,null,null,25,null,"A-Z, a-z, and hyphen"]
[null,null,null,"Govt Entity Contact Middle Initial (Box 15)",null,null,null,null,null,1,null,"A-Z, a-z, and hyphen"]
[null,null,null,"Govt Entity Contact Last Name (Box 15)",null,null,null,null,null,25,null,"A-Z, a-z, and hyphen"]
[null,null,null,"Govt Entity Contact Suffix (Box 15)",null,null,null,null,null,4,null,"A-Z, a-z, and hyphen"]
[null,null,null,"Govt Entity Contact Phone (Box 16)",null,null,null,null,null,15,null,"Numbers"]
[null,null,null,"Govt Entity Contact Phone Ext (Box 16)",null,null,null,null,null,5,null,"Numbers"]
[null,null,null,"Authoritative Transmittal Checkbox (Line 19)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Total 1095-C For Employer (Line 20)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Aggregated Group Member Checkbox (Line 21)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Qualifying Offer Method Checkbox (Line 22a)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"98% Offer Method Checkbox (Line 22d)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"All Yr Min Essential Coverage Checkbox (23a)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"All Yr Full-Time Employee Count (23b)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"All Yr Employee Count (23c)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"All Yr Aggregated Group Checkbox (23d)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Jan Min Essential Coverage Checkbox (24a)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Jan Full-Time Employee Count (24b)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Jan Employee Count (24c)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Jan Aggregated Group Checkbox (24d)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Feb Min Essential Coverage Checkbox (25a)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Feb Full-Time Employee Count (25b)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Feb Employee Count (25c)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Feb Aggregated Group Checkbox (25d)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Mar Min Essential Coverage Checkbox (26a)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Mar Full-Time Employee Count (26b)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Mar Employee Count (26c)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Mar Aggregated Group Checkbox (26d)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Apr Min Essential Coverage Checkbox (27a)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Apr Full-Time Employee Count (27b)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Apr Employee Count (27c)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Apr Aggregated Group Checkbox (27d)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"May Min Essential Coverage Checkbox (28a)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"May Full-Time Employee Count (28b)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"May Employee Count (28c)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"May Aggregated Group Checkbox (28d)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Jun Min Essential Coverage Checkbox (29a)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Jun Full-Time Employee Count (29b)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Jun Employee Count (29c)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Jun Aggregated Group Checkbox (29d)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Jul Min Essential Coverage Checkbox (30a)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Jul Full-Time Employee Count (30b)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Jul Employee Count (30c)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Jul Aggregated Group Checkbox (30d)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Aug Min Essential Coverage Checkbox (31a)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Aug Full-Time Employee Count (31b)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Aug Employee Count (31c)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Aug Aggregated Group Checkbox (31d)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Sep Min Essential Coverage Checkbox (32a)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Sep Full-Time Employee Count (32b)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Sep Employee Count (32c)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Sep Aggregated Group Checkbox (32d)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Oct Min Essential Coverage Checkbox (33a)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Oct Full-Time Employee Count (33b)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Oct Employee Count (33c)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Oct Aggregated Group Checkbox (33d)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Nov Min Essential Coverage Checkbox (34a)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Nov Full-Time Employee Count (34b)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Nov Employee Count (34c)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Nov Aggregated Group Checkbox (34d)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Dec Min Essential Coverage Checkbox (35a)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Dec Full-Time Employee Count (35b)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Dec Employee Count (35c)",null,null,null,null,null,7,null,"Numbers",null,null,9999999]
[null,null,null,"Dec Aggregated Group Checkbox (35d)",null,null,null,null,null,5,null,"1, True, X, Yes, or t to check box \n0, False, f, No or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Other ALE Member Name 1 (36)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (36)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (37)",null,null,null,null,null,34,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (37)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (38)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (38)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (39)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (39)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (40)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (40)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (41)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (41)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (42)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (42)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (43)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (43)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (44)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (44)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (45)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (45)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (46)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (46)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (47)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (47)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (48)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (48)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (49)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (49)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (50)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (50)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (51)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (51)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (52)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (52)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (53)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (53)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (54)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (54)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (55)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (55)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (56)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (56)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (57)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (57)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (58)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (58)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (59)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (59)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (60)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (60)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (61)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (61)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (62)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (62)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (63)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (63)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (64)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (64)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]
[null,null,null,"Other ALE Member Name 1 (65)",null,null,null,null,null,40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Other ALE Member EIN (65)",null,null,null,null,null,9,null,"Numbers",null,null,999999999]

{"sheet":"1095C Field Length And Format","index":6,"n_rows":115,"n_cols":7,"rows_kept":115,"cut":false,"hidden":true,"merged":[]}
["Field Name","Field Name","Maximum Length","Characters Allowed","Display Characters Allowed","Characters to Trim","Format"]
["Name of Employer 1 (Box 7)","Name of Employer 1 (Box 7)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Name of Employer 2 (Box 7)","Name of Employer 2 (Box 7)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Employer Address 1 (Box 9)","Employer Address 1 (Box 9)",40,"A-Z, a-z, 0-9, hyphen, and forward slash","A-Z, a-z, 0-9, hyphen, and forward slash"]
["Employer Address 2 (Box 9)","Employer Address 2 (Box 9)",40,"A-Z, a-z, 0-9, hyphen, and forward slash","A-Z, a-z, 0-9, hyphen, and forward slash"]
["Employer City (Box 11)","Employer City (Box 11)",20,"A-Z and a-z","A-Z and a-z"]
["Employer State  (Box 12)","Employer State  (Box 12)",2,"State","State Abbreviations",null,"WI"]
["Employer Zip (Box 13)","Employer Zip (Box 13)","5 or 9","Numbers","Numbers","Hyphens","99999 or 999999999"]
["Employer Foreign Address Indicator","Employer Foreign Address Indicator",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Employer Foreign State Name (Box 12)","Employer Foreign State Name (Box 12)",23,"A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe","A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe"]
["Employer Foreign Postal Code (Box 13)","Employer Foreign Postal Code (Box 13)",15,"A-Z, a-z, 0-9, period, slash, and hyphen","A-Z, a-z, 0-9, period, slash, and hyphen"]
["Employer Foreign Country Code (Box 13)","Employer Foreign Country Code (Box 13)",2,"Foreign Country Codes List","Foreign Country Codes List"]
["1094 Contact First Name","1094 Contact First Name",25,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["1094 Contact Middle Initial","1094 Contact Middle Initial",1,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["1094 Contact Last Name","1094 Contact Last Name",25,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["1094 Contact Suffix","1094 Contact Suffix",4,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["1095 Contact Phone (Box 10)","1095 Contact Phone (Box 10)",15,"Numbers","Numbers","Parentheses, spaces, and hyphens"]
["1095 Contact Phone Ext (Box 10)","1095 Contact Phone Ext (Box 10)",4,"Numbers","Numbers"]
["1094 Contact Phone","1094 Contact Phone",15,"Numbers","Numbers","Parentheses, spaces, and hyphens"]
["1094 Contact Phone Ext","1094 Contact Phone Ext",4,"Numbers","Numbers"]
["Employer Identification Number (Box 8)","Employer Identification Number (Box 8)",9,"Numbers","Numbers","Hyphens",999999999]
["Employer Misc Search One","Employer Misc Search One",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Employer Misc Search Two","Employer Misc Search Two",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
["Employee Social Security Number (Box 2)","Employee Social Security Number (Box 2)",9,"Numbers","Numbers","Hyphens",999999999]
["Employee First Name (Box 1)","Employee First Name (Box 1)",12,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"," "]
["Employee Middle Initial (Box 1)","Employee Middle Initial (Box 1)",1,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"," "]
["Employee Last Name (Box 1)","Employee Last Name (Box 1)",20,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"," "]
["Employee Suffix (Box 1)","Employee Suffix (Box 1)",4,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"," "]
["Employee Address 1 (Box 3)","Employee Address 1 (Box 3)",40,"A-Z, a-z, 0-9, hyphen, and forward slash","A-Z, a-z, 0-9, hyphen, and forward slash",null," "]
["Employee Address 2 (Box 3)","Employee Address 2 (Box 3)",40,"A-Z, a-z, 0-9, hyphen, and forward slash","A-Z, a-z, 0-9, hyphen, and forward slash",null," "]
["Employee City (Box 4)","Employee City (Box 4)",20,"A-Z and a-z","A-Z and a-z",null," "]
["Employee State (Box 5)","Employee State (Box 5)",2,"State","State Abbreviations",null,"WI"]
["Employee Zip (Box 6)","Employee Zip (Box 6)","5 or 9","Numbers","Numbers","Hyphens","99999 or 999999999"]
["Employee Foreign Address Indicator","Employee Foreign Address Indicator",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","Comma, ampersands"]
["Employee Foreign State Name (Box 5)","Employee Foreign State Name (Box 5)",23,"A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe","A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe","Comma, ampersands"]
["Employee Foreign Postal Code (Box 6)","Employee Foreign Postal Code (Box 6)",15,"A-Z, a-z, 0-9, period, slash, and hyphen","A-Z, a-z, 0-9, period, slash, and hyphen","Comma, ampersands"]
["Employee Foreign Country Code (Box 6)","Employee Foreign Country Code (Box 6)",2,"Foreign Country Codes List","Foreign Country Codes List","Comma, ampersands"]
["Employee Email (Online Retrieval)","Employee Email (Online Retrieval)",75,"A-Z, a-z, 0-9, !, #, $, %, &, ', *, +, /, =, ?, ^, _ , `, {, |, }, ~,-, ., and @","A-Z, a-z, 0-9, !, #, $, %, &, ', *, +, /, =, ?, ^, _ , `, {, |, }, ~,-, ., and @",null,"Employee@domain.com"]
["Employee Misc Search","Employee Misc Search",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
["Employee Age","Employee Age",3,"Numbers","Numbers"]
["Plan Start Month","Plan Start Month",2,"Plan Start Month","Plan Start Month: 00, 01, 02, 03, 04, 05, 06, 07, 08, 09, 10, 11, or 12",null,"00, 01, 02, 03, 04, 05, 06, 07, 08, 09, 10, 11, or 12"]
["All 12 Month Offer Of Coverage (Line 14)","All 12 Month Offer Of Coverage (Line 14)",2,"Offer of Coverage","Offer of Coverage: 1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U",null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
["Jan Offer Of Coverage (Line 14)","Jan Offer Of Coverage (Line 14)",2,"Offer of Coverage","Offer of Coverage: 1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U",null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
["Feb Offer Of Coverage (Line 14)","Feb Offer Of Coverage (Line 14)",2,"Offer of Coverage","Offer of Coverage: 1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U",null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
["Mar Offer Of Coverage (Line 14)","Mar Offer Of Coverage (Line 14)",2,"Offer of Coverage","Offer of Coverage: 1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U",null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
["Apr Offer Of Coverage (Line 14)","Apr Offer Of Coverage (Line 14)",2,"Offer of Coverage","Offer of Coverage: 1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U",null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
["May Offer Of Coverage (Line 14)","May Offer Of Coverage (Line 14)",2,"Offer of Coverage","Offer of Coverage: 1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U",null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
["Jun Offer Of Coverage (Line 14)","Jun Offer Of Coverage (Line 14)",2,"Offer of Coverage","Offer of Coverage: 1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U",null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
["Jul Offer Of Coverage (Line 14)","Jul Offer Of Coverage (Line 14)",2,"Offer of Coverage","Offer of Coverage: 1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U",null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
["Aug Offer Of Coverage (Line 14)","Aug Offer Of Coverage (Line 14)",2,"Offer of Coverage","Offer of Coverage: 1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U",null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
["Sep Offer Of Coverage (Line 14)","Sep Offer Of Coverage (Line 14)",2,"Offer of Coverage","Offer of Coverage: 1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U",null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
["Oct Offer Of Coverage (Line 14)","Oct Offer Of Coverage (Line 14)",2,"Offer of Coverage","Offer of Coverage: 1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U",null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
["Nov Offer Of Coverage (Line 14)","Nov Offer Of Coverage (Line 14)",2,"Offer of Coverage","Offer of Coverage: 1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U",null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
["Dec Offer Of Coverage (Line 14)","Dec Offer Of Coverage (Line 14)",2,"Offer of Coverage","Offer of Coverage: 1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U",null,"1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, or 1U"]
["Employee Required Contribution For All 12 Months (Line 15)","Employee Required Contribution For All 12 Months (Line 15)",7,"Numbers and decimal","Numbers and decimal","Commas and dollar signs",9999.99]
["Employee Required Contribution For Jan (Line 15)","Employee Required Contribution For Jan (Line 15)",7,"Numbers and decimal","Numbers and decimal","Commas and dollar signs",9999.99]
["Employee Required Contribution For Feb (Line 15)","Employee Required Contribution For Feb (Line 15)",7,"Numbers and decimal","Numbers and decimal","Commas and dollar signs",9999.99]
["Employee Required Contribution For Mar (Line 15)","Employee Required Contribution For Mar (Line 15)",7,"Numbers and decimal","Numbers and decimal","Commas and dollar signs",9999.99]
["Employee Required Contribution For Apr (Line 15)","Employee Required Contribution For Apr (Line 15)",7,"Numbers and decimal","Numbers and decimal","Commas and dollar signs",9999.99]
["Employee Required Contribution For May (Line 15)","Employee Required Contribution For May (Line 15)",7,"Numbers and decimal","Numbers and decimal","Commas and dollar signs",9999.99]
["Employee Required Contribution For Jun (Line 15)","Employee Required Contribution For Jun (Line 15)",7,"Numbers and decimal","Numbers and decimal","Commas and dollar signs",9999.99]
["Employee Required Contribution For Jul (Line 15)","Employee Required Contribution For Jul (Line 15)",7,"Numbers and decimal","Numbers and decimal","Commas and dollar signs",9999.99]
["Employee Required Contribution For Aug (Line 15)","Employee Required Contribution For Aug (Line 15)",7,"Numbers and decimal","Numbers and decimal","Commas and dollar signs",9999.99]
["Employee Required Contribution For Sep (Line 15)","Employee Required Contribution For Sep (Line 15)",7,"Numbers and decimal","Numbers and decimal","Commas and dollar signs",9999.99]
["Employee Required Contribution For Oct (Line 15)","Employee Required Contribution For Oct (Line 15)",7,"Numbers and decimal","Numbers and decimal","Commas and dollar signs",9999.99]
["Employee Required Contribution For Nov (Line 15)","Employee Required Contribution For Nov (Line 15)",7,"Numbers and decimal","Numbers and decimal","Commas and dollar signs",9999.99]
["Employee Required Contribution For Dec (Line 15)","Employee Required Contribution For Dec (Line 15)",7,"Numbers and decimal","Numbers and decimal","Commas and dollar signs",9999.99]
["Safe Harbor And Other Relief For All 12 Months (Line 16)","Safe Harbor And Other Relief For All 12 Months (Line 16)",2,"Safe Harbor","Safe Harbor: 2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H",null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
["Safe Harbor And Other Relief For Jan (Line 16)","Safe Harbor And Other Relief For Jan (Line 16)",2,"Safe Harbor","Safe Harbor: 2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H",null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
["Safe Harbor And Other Relief For Feb (Line 16)","Safe Harbor And Other Relief For Feb (Line 16)",2,"Safe Harbor","Safe Harbor: 2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H",null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
["Safe Harbor And Other Relief For Mar (Line 16)","Safe Harbor And Other Relief For Mar (Line 16)",2,"Safe Harbor","Safe Harbor: 2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H",null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
["Safe Harbor And Other Relief For Apr (Line 16)","Safe Harbor And Other Relief For Apr (Line 16)",2,"Safe Harbor","Safe Harbor: 2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H",null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
["Safe Harbor And Other Relief For May (Line 16)","Safe Harbor And Other Relief For May (Line 16)",2,"Safe Harbor","Safe Harbor: 2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H",null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
["Safe Harbor And Other Relief For Jun (Line 16)","Safe Harbor And Other Relief For Jun (Line 16)",2,"Safe Harbor","Safe Harbor: 2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H",null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
["Safe Harbor And Other Relief For Jul (Line 16)","Safe Harbor And Other Relief For Jul (Line 16)",2,"Safe Harbor","Safe Harbor: 2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H",null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
["Safe Harbor And Other Relief For Aug (Line 16)","Safe Harbor And Other Relief For Aug (Line 16)",2,"Safe Harbor","Safe Harbor: 2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H",null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
["Safe Harbor And Other Relief For Sep (Line 16)","Safe Harbor And Other Relief For Sep (Line 16)",2,"Safe Harbor","Safe Harbor: 2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H",null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
["Safe Harbor And Other Relief For Oct (Line 16)","Safe Harbor And Other Relief For Oct (Line 16)",2,"Safe Harbor","Safe Harbor: 2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H",null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
["Safe Harbor And Other Relief For Nov (Line 16)","Safe Harbor And Other Relief For Nov (Line 16)",2,"Safe Harbor","Safe Harbor: 2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H",null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
["Safe Harbor And Other Relief For Dec (Line 16)","Safe Harbor And Other Relief For Dec (Line 16)",2,"Safe Harbor","Safe Harbor: 2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H",null,"2A, 2B, 2C, 2D, 2E, 2F, 2G, or 2H"]
["Zip Code For All 12 Months (Line 17)","Zip Code For All 12 Months (Line 17)",5,"Numbers","Numbers","Hyphens",99999]
["Zip Code For Jan (Line 17)","Zip Code For Jan (Line 17)",5,"Numbers","Numbers","Hyphens",99999]
["Zip Code For Feb (Line 17)","Zip Code For Feb (Line 17)",5,"Numbers","Numbers","Hyphens",99999]
["Zip Code For Mar (Line 17)","Zip Code For Mar (Line 17)",5,"Numbers","Numbers","Hyphens",99999]
["Zip Code For Apr (Line 17)","Zip Code For Apr (Line 17)",5,"Numbers","Numbers","Hyphens",99999]
["Zip Code For May (Line 17)","Zip Code For May (Line 17)",5,"Numbers","Numbers","Hyphens",99999]
["Zip Code For Jun (Line 17)","Zip Code For Jun (Line 17)",5,"Numbers","Numbers","Hyphens",99999]
["Zip Code For Jul (Line 17)","Zip Code For Jul (Line 17)",5,"Numbers","Numbers","Hyphens",99999]
["Zip Code For Aug (Line 17)","Zip Code For Aug (Line 17)",5,"Numbers","Numbers","Hyphens",99999]
["Zip Code For Sep (Line 17)","Zip Code For Sep (Line 17)",5,"Numbers","Numbers","Hyphens",99999]
["Zip Code For Oct (Line 17)","Zip Code For Oct (Line 17)",5,"Numbers","Numbers","Hyphens",99999]
["Zip Code For Nov (Line 17)","Zip Code For Nov (Line 17)",5,"Numbers","Numbers","Hyphens",99999]
["Zip Code For Dec (Line 17)","Zip Code For Dec (Line 17)",5,"Numbers","Numbers","Hyphens",99999]
["Covered Individual Checkbox (Part III)","Covered Individual Checkbox (Part III)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)",null," "]
["Individual SSN Or TIN (b1) \nThrough\n Individual SSN Or TIN (b25)","Individual SSN Or TIN (b*",9,"Numbers","Numbers","Hyphens",999999999]
["DOB (c1)\nThrough \nDOB (c25)","DOB (c*",10,"Numbers and slashes","Numbers and slashes in the format mm/dd/yyyy",null,"99/99/9999"]
["First Name (a1) \nThrough\nFirst Name (a25)","First Name (a*",12,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["Middle Initial (a1)\nThrough\nMiddle Initial (a25)","Middle Initial (a*",1,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["Last Name (a1)\nThrough\nLast Name (a25)","Last Name (a*",20,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["Suffix (a1)\nThrough\nSuffix (a25)","Suffix (a*",4,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["Covered 12 Months (d1)\nThrough\nCovered 12 Months (d25)","Covered 12 Months (d*",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)",null," "]
["Jan (e1)\nThrough\nJan (e25)","Jan (e*",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)",null," "]
["Feb (e1)\nThrough\nFeb (e25)","Feb (e*",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)",null," "]
["Mar (e1)\nThrough\nMar (e25)","Mar (e*",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)",null," "]
["Apr (e1)\nThrough\nApr (e25)","Apr (e*",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)",null," "]
["May (e1)\nThrough\nMay (e25)","May (e*",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)",null," "]
["Jun (e1)\nThrough\nJun (e25)","Jun (e*",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)",null," "]
["Jul (e1)\nThrough\nJul (e25)","Jul (e*",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)",null," "]
["Aug (e1)\nThrough\nAug (e25)","Aug (e*",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)",null," "]
["Sep (e1)\nThrough\nSep (e25)","Sep (e*",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)",null," "]
["Oct (e1)\nThrough\nOct (e25)","Oct (e*",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)",null," "]
["Nov (e1)\nThrough\nNov (e25)","Nov (e*",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)",null," "]
["Dec (e1)\nThrough\nDec (e25)","Dec (e*",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)",null," "]
["Reprint Reason","Reprint Reason",9,"R, C, Reissued, Corrected","R, C, Reissued, Corrected"]
["ACA State Filing","ACA State Filing",8,"CA, DC, NJ, and/or RI","CA, DC, NJ, and/or RI"]

{"sheet":"Codes","index":7,"n_rows":258,"n_cols":10,"rows_kept":258,"cut":false,"hidden":true,"merged":[]}
["States","Alabama","AL",null,"Country Codes","Afghanistan","AF","ACA States","District of Columbia","DC"]
[null,"Alaska","AK",null,null,"Akrotiri","AX",null,"New Jersey","NJ"]
[null,"Arizona","AZ",null,null,"Albania","AL",null,"California","CA"]
[null,"Arkansas","AR",null,null,"Algeria","AG",null,"Rhode Island","RI"]
[null,"California","CA",null,null,"American Samoa","AQ"]
[null,"Colorado","CO",null,null,"Andorra","AN"]
[null,"Connecticut","CT",null,null,"Angola","AO"]
[null,"Delaware","DE",null,null,"Anguilla","AV"]
[null,"District of Columbia","DC",null,null,"Antarctica","AY"]
[null,"Florida","FL",null,null,"Antigua & Barbuda","AC"]
[null,"Georgia","GA",null,null,"Argentina","AR"]
[null,"Hawaii","HI",null,null,"Armenia","AM"]
[null,"Idaho","ID",null,null,"Aruba","AA"]
[null,"Illinois","IL",null,null,"Ashmore and Cartier Islands","AT"]
[null,"Indiana","IN",null,null,"Australia","AS"]
[null,"Iowa","IA",null,null,"Austria","AU"]
[null,"Kansas","KS",null,null,"Azerbaijan","AJ"]
[null,"Kentucky","KY",null,null,"Bahamas","BF"]
[null,"Louisiana","LA",null,null,"Bahrain","BA"]
[null,"Maine","ME",null,null,"Baker Island","FQ"]
[null,"Maryland","MD",null,null,"Bangladesh","BG"]
[null,"Massachusetts","MA",null,null,"Barbados","BB"]
[null,"Michigan","MI",null,null,"Belarus","BO"]
[null,"Minnesota","MN",null,null,"Belgium","BE"]
[null,"Mississippi","MS",null,null,"Belize","BH"]
[null,"Missouri","MO",null,null,"Benin","BN"]
[null,"Montana","MT",null,null,"Bermuda","BD"]
[null,"Nebraska","NE",null,null,"Bhutan","BT"]
[null,"Nevada","NV",null,null,"Bolivia","BL"]
[null,"New Hampshire","NH",null,null,"Bosnia-Herzegovina","BK"]
[null,"New Jersey","NJ",null,null,"Botswana","BC"]
[null,"New Mexico","NM",null,null,"Bouvet Island","BV"]
[null,"New York","NY",null,null,"Brazil","BR"]
[null,"North Carolina","NC",null,null,"British Indian Ocean Territory","IO"]
[null,"North Dakota","ND",null,null,"British Virgin Islands","VI"]
[null,"Ohio","OH",null,null,"Brunei","BX"]
[null,"Oklahoma","OK",null,null,"Bulgaria","BU"]
[null,"Oregon","OR",null,null,"Burkina Faso","UV"]
[null,"Pennsylvania","PA",null,null,"Burma","BM"]
[null,"Rhode Island","RI",null,null,"Burundi","BY"]
[null,"South Carolina","SC",null,null,"Cambodia","CB"]
[null,"South Dakota","SD",null,null,"Cameroon","CM"]
[null,"Tennessee","TN",null,null,"Canada","CA"]
[null,"Texas","TX",null,null,"Cape Verde","CV"]
[null,"Utah","UT",null,null,"Cayman Islands","CJ"]
[null,"Vermont","VT",null,null,"Central African Republic","CT"]
[null,"Virginia","VA",null,null,"Chad","CD"]
[null,"Washington","WA",null,null,"Chile","CI"]
[null,"West Virginia","WV",null,null,"China","CH"]
[null,"Wisconsin","WI",null,null,"Christmas Island","KT"]
[null,"Wyoming","WY",null,null,"Clipperton Island","IP"]
[null,null,"AA",null,null,"Cocos (Keeling) Islands","CK"]
[null,null,"AE",null,null,"Colombia","CO"]
[null,null,"AP",null,null,"Comoros","CN"]
[null,null,"AS",null,null,"Congo (Brazzaville)","CF"]
[null,null,"GU",null,null,"Congo (Kinshasa)","CG"]
[null,null,"MP",null,null,"Cook Islands","CW"]
[null,null,"PR",null,null,"Coral Sea Islands","CR"]
[null,null,"VI",null,null,"Costa Rica","CS"]
[null,null,null,null,null,"Cote D'Ivoire (Ivory Coast)","IV"]
[null,null,null,null,null,"Croatia","HR"]
[null,null,null,null,null,"Cuba","CU"]
[null,null,null,null,null,"Curacao","UC"]
[null,null,null,null,null,"Cyprus","CY"]
[null,null,null,null,null,"Czech Republic","EZ"]
[null,null,null,null,null,"Denmark","DA"]
[null,null,null,null,null,"Dhekelia","DX"]
[null,null,null,null,null,"Djibouti","DJ"]
[null,null,null,null,null,"Dominica","DO"]
[null,null,null,null,null,"Dominican Republic","DR"]
[null,null,null,null,null,"East Timor","TT"]
[null,null,null,null,null,"Ecuador","EC"]
[null,null,null,null,null,"Egypt","EG"]
[null,null,null,null,null,"El Salvador","ES"]
[null,null,null,null,null,"Equatorial Guinea","EK"]
[null,null,null,null,null,"Eritrea","ER"]
[null,null,null,null,null,"Estonia","EN"]
[null,null,null,null,null,"Ethiopia","ET"]
[null,null,null,null,null,"Falkland Islands (Islas Malvinas)","FK"]
[null,null,null,null,null,"Faroe Islands","FO"]
[null,null,null,null,null,"Federated States of Micronesia","FM"]
[null,null,null,null,null,"Fiji","FJ"]
[null,null,null,null,null,"Finland","FI"]
[null,null,null,null,null,"France","FR"]
[null,null,null,null,null,"French Polynesia","FP"]
[null,null,null,null,null,"French Southern and Antarctic Lands","FS"]
[null,null,null,null,null,"Gabon","GB"]
[null,null,null,null,null,"The Gambia","GA"]
[null,null,null,null,null,"Georgia","GG"]
[null,null,null,null,null,"Germany","GM"]
[null,null,null,null,null,"Ghana","GH"]
[null,null,null,null,null,"Gibraltar","GI"]
[null,null,null,null,null,"Greece","GR"]
[null,null,null,null,null,"Greenland","GL"]
[null,null,null,null,null,"Grenada","GJ"]
[null,null,null,null,null,"Guam","GQ"]
[null,null,null,null,null,"Guatemala","GT"]
[null,null,null,null,null,"Guernsey","GK"]
[null,null,null,null,null,"Guinea","GV"]
[null,null,null,null,null,"Guinea-Bissau","PU"]
[null,null,null,null,null,"Guyana","GY"]
[null,null,null,null,null,"Haiti","HA"]
[null,null,null,null,null,"Heard Island and McDonald Islands","HM"]
[null,null,null,null,null,"Holy See","VT"]
[null,null,null,null,null,"Honduras","HO"]
[null,null,null,null,null,"Hong Kong","HK"]
[null,null,null,null,null,"Howland Island","HQ"]
[null,null,null,null,null,"Hungary","HU"]
[null,null,null,null,null,"Iceland","IC"]
[null,null,null,null,null,"India","IN"]
[null,null,null,null,null,"Indonesia","ID"]
[null,null,null,null,null,"Iran","IR"]
[null,null,null,null,null,"Iraq","IZ"]
[null,null,null,null,null,"Ireland","EI"]
[null,null,null,null,null,"Israel","IS"]
[null,null,null,null,null,"Italy","IT"]
[null,null,null,null,null,"Jamaica","JM"]
[null,null,null,null,null,"Jan Mayen","JN"]
[null,null,null,null,null,"Japan","JA"]
[null,null,null,null,null,"Jarvis Island","DQ"]
[null,null,null,null,null,"Jersey","JE"]
[null,null,null,null,null,"Johnston Atoll","JQ"]
[null,null,null,null,null,"Jordan","JO"]
[null,null,null,null,null,"Kazakhstan","KZ"]
[null,null,null,null,null,"Kenya","KE"]
[null,null,null,null,null,"Kingman Reef","KQ"]
[null,null,null,null,null,"Kiribati","KR"]
[null,null,null,null,null,"Korea, Democratic People's Republic of (North)","KN"]
[null,null,null,null,null,"Korea, Republic of (South)","KS"]
[null,null,null,null,null,"Kosovo","KV"]
[null,null,null,null,null,"Kuwait","KU"]
[null,null,null,null,null,"Kyrgyzstan","KG"]
[null,null,null,null,null,"Laos","LA"]
[null,null,null,null,null,"Latvia","LG"]
[null,null,null,null,null,"Lebanon","LE"]
[null,null,null,null,null,"Lesotho","LT"]
[null,null,null,null,null,"Liberia","LI"]
[null,null,null,null,null,"Libya","LY"]
[null,null,null,null,null,"Liechtenstein","LS"]
[null,null,null,null,null,"Lithuania","LH"]
[null,null,null,null,null,"Luxembourg","LU"]
[null,null,null,null,null,"Macau","MC"]
[null,null,null,null,null,"Macedonia","MK"]
[null,null,null,null,null,"Madagascar","MA"]
[null,null,null,null,null,"Malawi","MI"]
[null,null,null,null,null,"Malaysia","MY"]
[null,null,null,null,null,"Maldives","MV"]
[null,null,null,null,null,"Mali","ML"]
[null,null,null,null,null,"Malta","MT"]
[null,null,null,null,null,"Man, Isle of","IM"]
[null,null,null,null,null,"Marshall Islands","RM"]
[null,null,null,null,null,"Mauritania","MR"]
[null,null,null,null,null,"Mauritius","MP"]
[null,null,null,null,null,"Mexico","MX"]
[null,null,null,null,null,"Midway Islands","MQ"]
[null,null,null,null,null,"Moldova","MD"]
[null,null,null,null,null,"Monaco","MN"]
[null,null,null,null,null,"Mongolia","MG"]
[null,null,null,null,null,"Montenegro","MJ"]
[null,null,null,null,null,"Montserrat","MH"]
[null,null,null,null,null,"Morocco","MO"]
[null,null,null,null,null,"Mozambique","MZ"]
[null,null,null,null,null,"Namibia","WA"]
[null,null,null,null,null,"Nauru","NR"]
[null,null,null,null,null,"Navassa Island","BQ"]
[null,null,null,null,null,"Nepal","NP"]
[null,null,null,null,null,"Netherlands","NL"]
[null,null,null,null,null,"New Caledonia","NC"]
[null,null,null,null,null,"New Zealand","NZ"]
[null,null,null,null,null,"Nicaragua","NU"]
[null,null,null,null,null,"Niger","NG"]
[null,null,null,null,null,"Nigeria","NI"]
[null,null,null,null,null,"Niue","NE"]
[null,null,null,null,null,"Norfolk Island","NF"]
[null,null,null,null,null,"Northern Mariana Islands","CQ"]
[null,null,null,null,null,"Norway","NO"]
[null,null,null,null,null,"Oman","MU"]
[null,null,null,null,null,"Other Country","OC"]
[null,null,null,null,null,"Pakistan","PK"]
[null,null,null,null,null,"Palau","PS"]
[null,null,null,null,null,"Palmyra Atoll","LQ"]
[null,null,null,null,null,"Panama","PM"]
[null,null,null,null,null,"Papua-New Guinea","PP"]
[null,null,null,null,null,"Paracel Islands","PF"]
[null,null,null,null,null,"Paraguay","PA"]
[null,null,null,null,null,"Peru","PE"]
[null,null,null,null,null,"Philippines","RP"]
[null,null,null,null,null,"Pitcairn Islands","PC"]
[null,null,null,null,null,"Poland","PL"]
[null,null,null,null,null,"Portugal","PO"]
[null,null,null,null,null,"Puerto Rico","RQ"]
[null,null,null,null,null,"Qatar","QA"]
[null,null,null,null,null,"Romania","RO"]
[null,null,null,null,null,"Russia","RS"]
[null,null,null,null,null,"Rwanda","RW"]
[null,null,null,null,null,"Saint Barthelemy","TB"]
[null,null,null,null,null,"Saint Martin","RN"]
[null,null,null,null,null,"Samoa","WS"]
[null,null,null,null,null,"San Marino","SM"]
[null,null,null,null,null,"Sao Tome and Principe","TP"]
[null,null,null,null,null,"Saudi Arabia","SA"]
[null,null,null,null,null,"Senegal","SG"]
[null,null,null,null,null,"Serbia","RI"]
[null,null,null,null,null,"Seychelles","SE"]
[null,null,null,null,null,"Sierra Leone","SL"]
[null,null,null,null,null,"Singapore","SN"]
[null,null,null,null,null,"Sint Maarten","NN"]
[null,null,null,null,null,"Slovakia","LO"]
[null,null,null,null,null,"Slovenia","SI"]
[null,null,null,null,null,"Solomon Islands","BP"]
[null,null,null,null,null,"Somalia","SO"]
[null,null,null,null,null,"South Africa","SF"]
[null,null,null,null,null,"South Georgia and the South Sandwich Islands","SX"]
[null,null,null,null,null,"South Sudan","OD"]
[null,null,null,null,null,"Spain","SP"]
[null,null,null,null,null,"Spratly Islands","PG"]
[null,null,null,null,null,"Sri Lanka","CE"]
[null,null,null,null,null,"St. Helena","SH"]
[null,null,null,null,null,"St. Kitts and Nevis","SC"]
[null,null,null,null,null,"St. Lucia Island","ST"]
[null,null,null,null,null,"St. Pierre and Miquelon","SB"]
[null,null,null,null,null,"St. Vincent and the Grenadines","VC"]
[null,null,null,null,null,"Sudan","SU"]
[null,null,null,null,null,"Suriname","NS"]
[null,null,null,null,null,"Svalbard","SV"]
[null,null,null,null,null,"Swaziland","WZ"]
[null,null,null,null,null,"Sweden","SW"]
[null,null,null,null,null,"Switzerland","SZ"]
[null,null,null,null,null,"Syria","SY"]
[null,null,null,null,null,"Taiwan","TW"]
[null,null,null,null,null,"Tajikistan","TI"]
[null,null,null,null,null,"Tanzania","TZ"]
[null,null,null,null,null,"Thailand","TH"]
[null,null,null,null,null,"Togo","TO"]
[null,null,null,null,null,"Tokelau","TL"]
[null,null,null,null,null,"Tonga","TN"]
[null,null,null,null,null,"Trinidad and Tobago","TD"]
[null,null,null,null,null,"Tunisia","TS"]
[null,null,null,null,null,"Turkey","TU"]
[null,null,null,null,null,"Turkmenistan","TX"]
[null,null,null,null,null,"Turks and Caicos Islands","TK"]
[null,null,null,null,null,"Tuvalu","TV"]
[null,null,null,null,null,"Uganda","UG"]
[null,null,null,null,null,"Ukraine","UP"]
[null,null,null,null,null,"United Arab Emirates","AE"]
[null,null,null,null,null,"United Kingdom (England, Northern Ireland, Scotland, and Wales)","UK"]
[null,null,null,null,null,"Uruguay","UY"]
[null,null,null,null,null,"Uzbekistan","UZ"]
[null,null,null,null,null,"Vanuatu","NH"]
[null,null,null,null,null,"Venezuela","VE"]
[null,null,null,null,null,"Vietnam","VM"]
[null,null,null,null,null,"Virgin Islands","VQ"]
[null,null,null,null,null,"Wake Island","WQ"]
[null,null,null,null,null,"Wallis and Futuna","WF"]
[null,null,null,null,null,"Western Sahara","WI"]
[null,null,null,null,null,"Yemen (Aden)","YM"]
[null,null,null,null,null,"Zambia","ZA"]
[null,null,null,null,null,"Zimbabwe","ZI"]

{"sheet":"1094C Field Length And Format","index":8,"n_rows":154,"n_cols":7,"rows_kept":154,"cut":false,"hidden":true,"merged":[]}
["Field Name","Field Name","Maximum Length","Characters Allowed","Display Characters Allowed","Characters to Trim","Format"]
["Name Of Employer 1 (Box 1)","Name Of Employer 1 (Box 1)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Name Of Employer 2 (Box 1)","Name Of Employer 2 (Box 1)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Employer Address 1 (Box 3)","Employer Address 1 (Box 3)",40,"A-Z, a-z, 0-9, hyphen, and forward slash","A-Z, a-z, 0-9, hyphen, and forward slash"]
["Employer Address 2 (Box 3)","Employer Address 2 (Box 3)",40,"A-Z, a-z, 0-9, hyphen, and forward slash","A-Z, a-z, 0-9, hyphen, and forward slash"]
["Employer City (Box 4)","Employer City (Box 4)",20,"A-Z and a-z","A-Z and a-z"]
["Employer State (Box 5)","Employer State (Box 5)",2,"State","State Abbreviations",null,"WI"]
["Employer Zip (Box 6)","Employer Zip (Box 6)","5 or 9","Numbers","Numbers","Hyphens","99999 or 999999999"]
["Employer Foreign Address Indicator","Employer Foreign Address Indicator",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Employer Foreign State Name (Box 5)","Employer Foreign State Name (Box 5)",23,"A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe","A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe"]
["Employer Foreign Postal Code (Box 6)","Employer Foreign Postal Code (Box 6)",15,"A-Z, a-z, 0-9, period, slash, and hyphen","A-Z, a-z, 0-9, period, slash, and hyphen"]
["Employer Foreign Country Code (Box 6)","Employer Foreign Country Code (Box 6)",2,"Foreign Country Codes List","Foreign Country Codes List"]
["1094 Contact First Name (Box 7)","1094 Contact First Name (Box 7)",25,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["1094 Contact Middle Initial (Box 7)","1094 Contact Middle Initial (Box 7)",1,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["1094 Contact Last Name (Box 7)","1094 Contact Last Name (Box 7)",25,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["1094 Contact Suffix (Box 7)","1094 Contact Suffix (Box 7)",4,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["1094 Contact Phone (Box 8)","1094 Contact Phone (Box 8)",15,"Numbers","Numbers","Parentheses, spaces, and hyphens"]
["1094 Contact Phone Ext (Box 8)","1094 Contact Phone Ext (Box 8)",4,"Numbers","Numbers"]
["Employer Identification Number (Box 2)","Employer Identification Number (Box 2)",9,"Numbers","Numbers","Hyphens",999999999]
["Govt Entity Name 1 (Box 9)","Govt Entity Name 1 (Box 9)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Govt Entity Name 2 (Box 9)","Govt Entity Name 2 (Box 9)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
["Govt Entity Employer Identification Number (Box 10)","Govt Entity Employer Identification Number (Box 10)",9,"Numbers","Numbers","Hyphens",999999999]
["Govt Entity Address 1 (Box 11)","Govt Entity Address 1 (Box 11)",40,"A-Z, a-z, 0-9, hyphen, and forward slash","A-Z, a-z, 0-9, hyphen, and forward slash"]
["Govt Entity Address 2 (Box 11)","Govt Entity Address 2 (Box 11)",40,"A-Z, a-z, 0-9, hyphen, and forward slash","A-Z, a-z, 0-9, hyphen, and forward slash"]
["Govt Entity City (Box 12)","Govt Entity City (Box 12)",20,"A-Z and a-z","A-Z and a-z"]
["Govt Entity State (Box 13)","Govt Entity State (Box 13)",2,"State","State Abbreviations",null,"WI"]
["Govt Entity Zip (Box 14)","Govt Entity Zip (Box 14)","5 or 9","Numbers","Numbers","Hyphens","99999 or 999999999"]
["Govt Entity Foreign Address Indicator","Govt Entity Foreign Address Indicator",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Govt Entity Foreign State Name (Box 13)","Govt Entity Foreign State Name (Box 13)",23,"A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe","A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe"]
["Govt Entity Foreign Postal Code (Box 14)","Govt Entity Foreign Postal Code (Box 14)",15,"A-Z, a-z, 0-9, period, slash, and hyphen","A-Z, a-z, 0-9, period, slash, and hyphen"]
["Govt Entity Foreign Country Code (Box 14)","Govt Entity Foreign Country Code (Box 14)",2,"Foreign Country Codes List","Foreign Country Codes List"]
["Govt Entity Contact First Name (Box 15)","Govt Entity Contact First Name (Box 15)",25,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["Govt Entity Contact Middle Initial (Box 15)","Govt Entity Contact Middle Initial (Box 15)",1,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["Govt Entity Contact Last Name (Box 15)","Govt Entity Contact Last Name (Box 15)",25,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["Govt Entity Contact Suffix (Box 15)","Govt Entity Contact Suffix (Box 15)",4,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["Govt Entity Contact Phone (Box 16)","Govt Entity Contact Phone (Box 16)",15,"Numbers","Numbers","Parentheses, spaces, and hyphens"]
["Govt Entity Contact Phone Ext (Box 16)","Govt Entity Contact Phone Ext (Box 16)",4,"Numbers","Numbers"]
["Authoritative Transmittal Checkbox (Line 19)","Authoritative Transmittal Checkbox (Line 19)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Total 1095-C For Employer (Line 20)","Total 1095-C For Employer (Line 20)",7,"Numbers","Numbers",null,9999999]
["Aggregated Group Member Checkbox (Line 21)","Aggregated Group Member Checkbox (Line 21)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Qualifying Offer Method Checkbox (Line 22a)","Qualifying Offer Method Checkbox (Line 22a)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["98% Offer Method Checkbox (Line 22d)","98% Offer Method Checkbox (Line 22d)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["All Yr Min Essential Coverage Checkbox (23a)","All Yr Min Essential Coverage Checkbox (23a)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["All Yr Full-Time Employee Count (23b)","All Yr Full-Time Employee Count (23b)",7,"Numbers","Numbers",null,9999999]
["All Yr Employee Count (23c)","All Yr Employee Count (23c)",7,"Numbers","Numbers",null,9999999]
["All Yr Aggregated Group Checkbox (23d)","All Yr Aggregated Group Checkbox (23d)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Jan Min Essential Coverage Checkbox (24a)","Jan Min Essential Coverage Checkbox (24a)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Jan Full-Time Employee Count (24b)","Jan Full-Time Employee Count (24b)",7,"Numbers","Numbers",null,9999999]
["Jan Employee Count (24c)","Jan Employee Count (24c)",7,"Numbers","Numbers",null,9999999]
["Jan Aggregated Group Checkbox (24d)","Jan Aggregated Group Checkbox (24d)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Feb Min Essential Coverage Checkbox (25a)","Feb Min Essential Coverage Checkbox (25a)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Feb Full-Time Employee Count (25b)","Feb Full-Time Employee Count (25b)",7,"Numbers","Numbers",null,9999999]
["Feb Employee Count (25c)","Feb Employee Count (25c)",7,"Numbers","Numbers",null,9999999]
["Feb Aggregated Group Checkbox (25d)","Feb Aggregated Group Checkbox (25d)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Mar Min Essential Coverage Checkbox (26a)","Mar Min Essential Coverage Checkbox (26a)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Mar Full-Time Employee Count (26b)","Mar Full-Time Employee Count (26b)",7,"Numbers","Numbers",null,9999999]
["Mar Employee Count (26c)","Mar Employee Count (26c)",7,"Numbers","Numbers",null,9999999]
["Mar Aggregated Group Checkbox (26d)","Mar Aggregated Group Checkbox (26d)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Apr Min Essential Coverage Checkbox (27a)","Apr Min Essential Coverage Checkbox (27a)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Apr Full-Time Employee Count (27b)","Apr Full-Time Employee Count (27b)",7,"Numbers","Numbers",null,9999999]
["Apr Employee Count (27c)","Apr Employee Count (27c)",7,"Numbers","Numbers",null,9999999]
["Apr Aggregated Group Checkbox (27d)","Apr Aggregated Group Checkbox (27d)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["May Min Essential Coverage Checkbox (28a)","May Min Essential Coverage Checkbox (28a)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["May Full-Time Employee Count (28b)","May Full-Time Employee Count (28b)",7,"Numbers","Numbers",null,9999999]
["May Employee Count (28c)","May Employee Count (28c)",7,"Numbers","Numbers",null,9999999]
["May Aggregated Group Checkbox (28d)","May Aggregated Group Checkbox (28d)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Jun Min Essential Coverage Checkbox (29a)","Jun Min Essential Coverage Checkbox (29a)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Jun Full-Time Employee Count (29b)","Jun Full-Time Employee Count (29b)",7,"Numbers","Numbers",null,9999999]
["Jun Employee Count (29c)","Jun Employee Count (29c)",7,"Numbers","Numbers",null,9999999]
["Jun Aggregated Group Checkbox (29d)","Jun Aggregated Group Checkbox (29d)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Jul Min Essential Coverage Checkbox (30a)","Jul Min Essential Coverage Checkbox (30a)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Jul Full-Time Employee Count (30b)","Jul Full-Time Employee Count (30b)",7,"Numbers","Numbers",null,9999999]
["Jul Employee Count (30c)","Jul Employee Count (30c)",7,"Numbers","Numbers",null,9999999]
["Jul Aggregated Group Checkbox (30d)","Jul Aggregated Group Checkbox (30d)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Aug Min Essential Coverage Checkbox (31a)","Aug Min Essential Coverage Checkbox (31a)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Aug Full-Time Employee Count (31b)","Aug Full-Time Employee Count (31b)",7,"Numbers","Numbers",null,9999999]
["Aug Employee Count (31c)","Aug Employee Count (31c)",7,"Numbers","Numbers",null,9999999]
["Aug Aggregated Group Checkbox (31d)","Aug Aggregated Group Checkbox (31d)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Sep Min Essential Coverage Checkbox (32a)","Sep Min Essential Coverage Checkbox (32a)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Sep Full-Time Employee Count (32b)","Sep Full-Time Employee Count (32b)",7,"Numbers","Numbers",null,9999999]
["Sep Employee Count (32c)","Sep Employee Count (32c)",7,"Numbers","Numbers",null,9999999]
["Sep Aggregated Group Checkbox (32d)","Sep Aggregated Group Checkbox (32d)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Oct Min Essential Coverage Checkbox (33a)","Oct Min Essential Coverage Checkbox (33a)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Oct Full-Time Employee Count (33b)","Oct Full-Time Employee Count (33b)",7,"Numbers","Numbers",null,9999999]
["Oct Employee Count (33c)","Oct Employee Count (33c)",7,"Numbers","Numbers",null,9999999]
["Oct Aggregated Group Checkbox (33d)","Oct Aggregated Group Checkbox (33d)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Nov Min Essential Coverage Checkbox (34a)","Nov Min Essential Coverage Checkbox (34a)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Nov Full-Time Employee Count (34b)","Nov Full-Time Employee Count (34b)",7,"Numbers","Numbers",null,9999999]
["Nov Employee Count (34c)","Nov Employee Count (34c)",7,"Numbers","Numbers",null,9999999]
["Nov Aggregated Group Checkbox (34d)","Nov Aggregated Group Checkbox (34d)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Dec Min Essential Coverage Checkbox (35a)","Dec Min Essential Coverage Checkbox (35a)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Dec Full-Time Employee Count (35b)","Dec Full-Time Employee Count (35b)",7,"Numbers","Numbers",null,9999999]
["Dec Employee Count (35c)","Dec Employee Count (35c)",7,"Numbers","Numbers",null,9999999]
["Dec Aggregated Group Checkbox (35d)","Dec Aggregated Group Checkbox (35d)",5,"1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)","1, True, X, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
["Other ALE Member Name 1 (36)","Other ALE Member Name 1 (36)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (36)","Other ALE Member EIN (36)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (37)","Other ALE Member Name 1 (37)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (37)","Other ALE Member EIN (37)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (38)","Other ALE Member Name 1 (38)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (38)","Other ALE Member EIN (38)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (39)","Other ALE Member Name 1 (39)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (39)","Other ALE Member EIN (39)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (40)","Other ALE Member Name 1 (40)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (40)","Other ALE Member EIN (40)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (41)","Other ALE Member Name 1 (41)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (41)","Other ALE Member EIN (41)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (42)","Other ALE Member Name 1 (42)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (42)","Other ALE Member EIN (42)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (43)","Other ALE Member Name 1 (43)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (43)","Other ALE Member EIN (43)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (44)","Other ALE Member Name 1 (44)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (44)","Other ALE Member EIN (44)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (45)","Other ALE Member Name 1 (45)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (45)","Other ALE Member EIN (45)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (46)","Other ALE Member Name 1 (46)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (46)","Other ALE Member EIN (46)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (47)","Other ALE Member Name 1 (47)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (47)","Other ALE Member EIN (47)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (48)","Other ALE Member Name 1 (48)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (48)","Other ALE Member EIN (48)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (49)","Other ALE Member Name 1 (49)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (49)","Other ALE Member EIN (49)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (50)","Other ALE Member Name 1 (50)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (50)","Other ALE Member EIN (50)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (51)","Other ALE Member Name 1 (51)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (51)","Other ALE Member EIN (51)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (52)","Other ALE Member Name 1 (52)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (52)","Other ALE Member EIN (52)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (53)","Other ALE Member Name 1 (53)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (53)","Other ALE Member EIN (53)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (54)","Other ALE Member Name 1 (54)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (54)","Other ALE Member EIN (54)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (55)","Other ALE Member Name 1 (55)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (55)","Other ALE Member EIN (55)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (56)","Other ALE Member Name 1 (56)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (56)","Other ALE Member EIN (56)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (57)","Other ALE Member Name 1 (57)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (57)","Other ALE Member EIN (57)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (58)","Other ALE Member Name 1 (58)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (58)","Other ALE Member EIN (58)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (59)","Other ALE Member Name 1 (59)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (59)","Other ALE Member EIN (59)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (60)","Other ALE Member Name 1 (60)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (60)","Other ALE Member EIN (60)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (61)","Other ALE Member Name 1 (61)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (61)","Other ALE Member EIN (61)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (62)","Other ALE Member Name 1 (62)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (62)","Other ALE Member EIN (62)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (63)","Other ALE Member Name 1 (63)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (63)","Other ALE Member EIN (63)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (64)","Other ALE Member Name 1 (64)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (64)","Other ALE Member EIN (64)",9,"Numbers","Numbers","Hyphens",999999999]
["Other ALE Member Name 1 (65)","Other ALE Member Name 1 (65)",40,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period","Comma"]
["Other ALE Member EIN (65)","Other ALE Member EIN (65)",9,"Numbers","Numbers","Hyphens",999999999]