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["2023 Tax Year (Do Not Delete)"]
["Name of Issuer 1 (Box 16)","Name of Issuer 2 (Box 16)","Issuer Address 1 (Box 19)","Issuer Address 2 (Box 19)","Issuer City (Box 20)","Issuer State (Box 21)","Issuer Zip (Box 22)","Issuer Foreign Address Indicator","Issuer Foreign State Name (Box 21)","Issuer Foreign Postal Code (Box 22)","Issuer Foreign Country Code (Box 22)","1094 Contact First Name","1094 Contact Middle Initial","1094 Contact Last Name","1094 Contact Suffix","1094 Contact Phone","1094 Contact Phone Ext","1095 Contact Phone (Box 18)","1095 Contact Phone Ext (Box 18)","Issuer Identification Number (Box 17)","Issuer Misc Search One","Issuer Misc Search Two","Name Of Sponsoring Employer 1 (Box 10)","Name Of Sponsoring Employer 2 (Box 10)","Sponsoring Employer Address 1 (Box 12)","Sponsoring Employer Address 2 (Box 12)","Sponsoring Employer City (Box 13)","Sponsoring Employer State (Box 14)","Sponsoring Employer Zip (Box 15)","Sponsoring Employer Foreign Address Indicator","Sponsoring Employer Foreign State Name (Box 14)","Sponsoring Employer Foreign Postal Code (Box 15)","Sponsoring Employer Foreign Country Code (Box 15)","Sponsoring Employer Identification Number (Box 11)","Responsible Individual SSN Or TIN (Box 2)","Responsible Individual Date Of Birth (Box 3)","Responsible Individual First Name (Box 1)","Responsible Individual Middle Initial (Box 1)","Responsible Individual Last Name (Box 1)","Responsible Individual Suffix (Box 1)","Responsible Individual Address 1 (Box 4)","Responsible Individual Address 2 (Box 4)","Responsible Individual City (Box 5)","Responsible Individual State (Box 6)","Responsible Individual Zip (Box 7)","ACA State Filing","Responsible Individual Foreign Address Indicator","Responsible Individual Foreign State Name (Box 6)","Responsible Individual Foreign Postal Code (Box 7)","Responsible Individual Foreign Country Code (Box 7)","Responsible Individual Email (Online Retrieval)","Responsible Individual Misc Search","Origin Of Health Coverage","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"]
["Company One",null,"333 Main Street",null,"Grand Rapids","MI","495011157",null,null,null,null,"Dave",null,"Wall",null,"5559876543",null,"5551231234","1234","111111122","DoNotFile",null,"DOMESTIC EMPLOYER ONE",null,"132 Road",null,"Acity","CA",90222,null,null,null,null,"515050505","111334444","2/21/1970","Jackson","B","Fall","Sr","555 Western St",null,"Grand Rapids","MI",49501,"CA",null,null,null,null,null,null,"B","111334444",null,"Jackson","B","Fall","Sr",true,null,null,null,null,null,null,null,null,null,null,null,null,"554657777",null,"Joanne","A","Fall",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"444546666",null,"Jane","W","Fall",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"117767777",null,"Joe","P","Fall",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"115666666",null,"Sam","J","Fall",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"115555554",null,"Fred","J","Fall",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"233445555",null,"Jim","P","Fall",null,true]
["Company One",null,"333 Main Street",null,"Grand Rapids","MI","495011157",null,null,null,null,"Dave",null,"Wall",null,"5559876543",null,"5551231234","1234","111111122","DoNotFile",null,"DOMESTIC EMPLOYER ONE",null,"132 Road",null,"Acity","CA",90222,null,null,null,null,"515050505","111325555","01/06/1980","Sally","C","Spring",null,"753 Square Dr","Apt 2786","Grand Rapids","MI",49501,"DC",null,null,null,null,null,null,"B","111325555","01/06/1980","Sally","C","Spring",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"","06/02/2005","John","A","Spring",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"555657777",null,"Nan","A","Spring",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"444546666",null,"Janet","W","Spring",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"116777777",null,"Joe","P","Spring",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"116666665",null,"Sam","J","Spring",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"215555555",null,"Fred","J","Spring",null,true]
["Company One",null,"333 Main Street",null,"Grand Rapids","MI","495011157",null,null,null,null,"Dave",null,"Wall",null,"5559876543",null,"5551231234","1234","111111122","DoNotFile",null,"DOMESTIC EMPLOYER ONE",null,"132 Road",null,"Acity","CA",90222,null,null,null,null,"515050505","222446666","3/9/1993","Paula","R","Summer",null,"222 Road Way",null,"Grand Rapids","MI",49501,"CA DC",null,null,null,null,null,null,"B","222446666",null,"Paula","R","Summer",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"112213333",null,"Jane","F","Summer",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"111216648",null,"John","A","Summer",null,true,null,null,null,null,null,null,null,null,null,null,null,null,null,"01/31/2013","Sally","A","Summer",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"443556666",null,"Jacob","W","Summer",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"117777776",null,"Joe","P","Summer",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"216666666",null,"Sam","J","Summer",null,true]
["Company One",null,"333 Main Street",null,"Grand Rapids","MI","495011157",null,null,null,null,"Dave",null,"Wall",null,"5559876543",null,"5551231234","1234","111111122","DoNotFile",null,"DOMESTIC EMPLOYER ONE",null,"132 Road",null,"Acity","CA",90222,null,null,null,null,"515050505","333557777",null,"Daniel","J","Winter",null,"N111 County Trunk G",null,"Grand Rapids","MI",49501,"NJ",null,null,null,null,null,null,"B","333557777",null,"Daniel","J","Winter",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"221324444",null,"Pam","J","Winter",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"111213333",null,"Jane","F","Winter",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"111216648",null,"John","A","Winter",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"554667777",null,"Sally","A","Winter",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"444556665",null,"Janet","W","Winter",null,true,null,null,null,null,null,null,null,null,null,null,null,null,"217777777",null,"Joe","P","Winter",null,true]
["Company Two","Second Payer Name","456 East Ave","Suite 400","Green Bay","WI",54301,null,null,null,null,"Jean",null,"Douglas",null,"5556549871",null,"5554324321",null,"222222233","DoNotFile",null,"DOMESTIC EMPLOYER TWO",null,"321 Street",null,"Atown","CA","90221",null,null,null,null,"515050509","444668888",null,"Alfred","B","Cousins",null,"123 Somewhere Dr",null,"Green Bay","WI",54301,"NJ CA",null,null,null,null,null,null,"B","444668888",null,"Alfred","B","Cousins",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"332435555",null,"Jim","P","Cousins",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"222324444",null,"Pam","J","Cousins",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"111213333",null,"Courtney","F","Cousins",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"110226648",null,"John","A","Cousins",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"555667776",null,"Sally","A","Cousins",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"344556666",null,"Jane","W","Cousins",null,null,false,true,true,true,true,true,true,true,true,true,true,true]
["Company Two","Second Payer Name","456 East Ave","Suite 400","Green Bay","WI",54301,null,null,null,null,"Jean",null,"Douglas",null,"5556549871",null,"5554324321",null,"222222233","DoNotFile",null,"DOMESTIC EMPLOYER TWO",null,"321 Street",null,"Atown","CA","90221",null,null,null,null,"515050509","555789999","05/13/2000","Deanna","E","Franklin",null,"444 Sunrise Dr","Suite 5B","Green Bay","WI",54301,null,null,null,null,null,null,null,"B","555789999","05/13/2000","Deanna","E","Franklin",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"114545555",null,"Fred","J","Franklin",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"333435555",null,"Jim","P","Franklin",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"222324444",null,"Pam","J","Franklin",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"110223333",null,"Fran","F","Franklin",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"111226647",null,"John","A","Franklin",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"455667777",null,"Sally","A","Franklin",null,null,false,true,true,true,true,true,true,true,true,true,true,true]
["Company Two","Second Payer Name","456 East Ave","Suite 400","Green Bay","WI",54301,null,null,null,null,"Jean",null,"Douglas",null,"5556549871",null,"5554324321",null,"222222233","DoNotFile",null,"DOMESTIC EMPLOYER TWO",null,"321 Street",null,"Atown","CA","90221",null,null,null,null,"515050509","777553333",null,"George","H","Ivy",null,"456 Oak St",null,"Green Bay","WI",54301,"CA NJ",null,null,null,null,null,null,"B","777553333",null,"George","H","Ivy",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"115656666",null,"Sam","J","Ivy",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"115545555",null,"Fred","J","Ivy",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"333435555",null,"Jim","P","Ivy",null,null,false,true,true,true,true,true,true,true,true,true,true,true,null,"03/15/2012","Pam","J","Ivy",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"111223332",null,"Jane","F","Ivy",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"211226648",null,"John","A","Ivy",null,null,false,true,true,true,true,true,true,true,true,true,true,true]
["Company Two","Second Payer Name","456 East Ave","Suite 400","Green Bay","WI",54301,null,null,null,null,"Jean",null,"Douglas",null,"5556549871",null,"5554324321",null,"222222233","DoNotFile",null,"DOMESTIC EMPLOYER TWO",null,"321 Street",null,"Atown","CA","90221",null,null,null,null,"515050509","888775555",null,"Jane","K","Lee",null,"1222 Maple Avenue",null,"Green Bay","WI",54301,null,null,null,null,null,null,null,"B","888775555",null,"Jane","K","Lee",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"116767777",null,"Joe","P","Lee",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"116656666",null,"Sam","J","Lee",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"115545555",null,"Fred","J","Lee",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"332445555",null,"Jim","P","Lee",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"222334443",null,"Pam","J","Lee",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"211223333",null,"Janet","F","Lee",null,null,false,true,true,true,true,true,true,true,true,true,true,true]
["Company Two","Second Payer Name","456 East Ave","Suite 400","Green Bay","WI",54301,null,null,null,null,"Jean",null,"Douglas",null,"5556549871",null,"5554324321",null,"222222233","DoNotFile",null,"DOMESTIC EMPLOYER TWO",null,"321 Street",null,"Atown","CA","90221",null,null,null,null,"515050509","432225454",null,"Molly","N","Oliver",null,"1555 W 121st St",null,"Green Bay","WI",54301,null,null,null,null,null,null,null,"B","432225454",null,"Molly","N","Oliver",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"443546666",null,"Amy","W","Oliver",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"117767777",null,"Joe","P","Oliver",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"116656666",null,"Sam","J","Oliver",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"114555555",null,"Fred","J","Oliver",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"333445554",null,"Jim","P","Oliver",null,null,false,true,true,true,true,true,true,true,true,true,true,true,"122334444",null,"Paula","J","Oliver",null,null,false,true,true,true,true,true,true,true,true,true,true,true]

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[null,"Importing Form 1095-B Into Yearli\nA guide to formatting your data before importing it into Yearli."]
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[null,null,"Enter Template"]
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[null,null,"Home",null,null,"Template",null,null,null,"Help",null,null,null,"Field Name & Length"]
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[]
[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."]

{"sheet":"Help","index":2,"n_rows":51,"n_cols":14,"rows_kept":51,"cut":false,"hidden":false,"merged":[[46,2,46,5],[46,7,46,10],[46,12,46,15],[41,2,41,9],[1,5,2,8],[6,1,10,16],[14,2,14,3],[14,5,14,7],[14,9,14,11],[14,13,14,15],[17,1,17,16],[18,1,18,16],[33,1,34,16],[36,2,36,8],[39,1,39,16],[28,2,28,16],[44,2,44,5],[44,7,44,10],[44,12,44,15],[45,2,45,5],[45,7,45,9],[47,2,47,5],[48,2,48,5],[48,7,48,10],[48,12,48,15],[49,2,49,5],[49,7,49,9],[50,2,50,5],[50,7,50,10],[50,12,50,15],[51,2,51,5],[51,7,51,9]]}
[]
[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 hyphens"]
[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 Misc Search and Reprint Reason columns apply to Yearli Desktop and Premier only"]
[null,"•","The Online Retrieval System will use the field \"Responsible Individual 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,"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,null,"Available: 24 hours a day - 7 days a week - 365 days a year."]
[]
[]
[null,null,"Yearli Performance",null,null,null,null,"Yearli Premier",null,null,null,null,"Yearli Desktop"]
[]
[null,null,"Search Knowledge Base",null,null,null,null,"Search Knowledge Base",null,null,null,null,"Search Knowledge Base"]
[]
[null,null,"Phone: 877.789.1946",null,null,null,null,"Phone: 877.789.1946",null,null,null,null,"Phone: 920.339.3200"]
[]
[null,null,"Chat Online Now",null,null,null,null,"Chat Online Now",null,null,null,null,"Chat Online Now"]

{"sheet":"Field Name & Length","index":3,"n_rows":92,"n_cols":15,"rows_kept":92,"cut":false,"hidden":false,"merged":[[30,3,30,8],[6,1,10,16],[28,3,28,8],[27,3,27,8],[24,3,24,8],[25,3,25,8],[26,3,26,8],[24,11,24,13],[25,11,25,13],[26,11,26,13],[27,11,27,13],[28,11,28,13],[29,11,29,13],[30,11,30,13],[1,5,2,8],[14,2,14,3],[14,5,14,7],[18,9,18,10],[23,3,23,8],[14,9,14,11],[18,11,18,13],[19,11,19,13],[20,11,20,13],[21,11,21,13],[22,11,22,13],[23,11,23,13],[89,3,89,8],[39,3,39,8],[31,3,31,8],[32,3,32,8],[33,3,33,8],[84,3,84,8],[85,3,85,8],[86,3,86,8],[87,3,87,8],[88,3,88,8],[79,3,79,8],[80,3,80,8],[81,3,81,8],[82,3,82,8],[83,3,83,8],[74,3,74,8],[75,3,75,8],[76,3,76,8],[77,3,77,8],[78,3,78,8],[69,3,69,8],[70,3,70,8],[71,3,71,8],[72,3,72,8],[73,3,73,8],[60,3,60,8],[61,3,61,8],[62,3,62,8],[63,3,63,8],[64,3,64,8],[65,3,65,8],[66,3,66,8],[67,3,67,8],[68,3,68,8],[55,3,55,8],[45,3,45,8],[50,3,50,8],[51,3,51,8],[52,3,52,8],[53,3,53,8],[54,3,54,8],[46,3,46,8],[47,3,47,8],[90,3,90,8],[48,3,48,8],[49,3,49,8],[37,3,37,8],[14,13,14,15],[18,3,18,8],[19,3,19,8],[20,3,20,8],[21,3,21,8],[22,3,22,8],[40,3,40,8],[41,3,41,8],[29,3,29,8],[34,3,34,8],[35,3,35,8],[36,3,36,8],[38,3,38,8],[56,3,56,8],[57,3,57,8],[58,3,58,8],[59,3,59,8],[42,3,42,8],[43,3,43,8],[44,3,44,8],[36,11,36,13],[37,11,37,13],[38,11,38,13],[39,11,39,13],[40,11,40,13],[31,11,31,13],[32,11,32,13],[33,11,33,13],[34,11,34,13],[35,11,35,13],[46,11,46,13],[47,11,47,13],[48,11,48,13],[49,11,49,13],[50,11,50,13],[41,11,41,13],[42,11,42,13],[43,11,43,13],[44,11,44,13],[45,11,45,13],[56,11,56,13],[57,11,57,13],[58,11,58,13],[59,11,59,13],[60,11,60,13],[51,11,51,13],[52,11,52,13],[53,11,53,13],[54,11,54,13],[55,11,55,13],[66,11,66,13],[67,11,67,13],[68,11,68,13],[69,11,69,13],[70,11,70,13],[61,11,61,13],[62,11,62,13],[63,11,63,13],[64,11,64,13],[65,11,65,13],[76,11,76,13],[77,11,77,13],[78,11,78,13],[79,11,79,13],[80,11,80,13],[71,11,71,13],[72,11,72,13],[73,11,73,13],[74,11,74,13],[75,11,75,13],[91,11,91,13],[86,11,86,13],[87,11,87,13],[88,11,88,13],[89,11,89,13],[90,11,90,13],[81,11,81,13],[82,11,82,13],[83,11,83,13],[84,11,84,13],[85,11,85,13]]}
[]
[null,null,null,null,null,"Version 5.5"]
[]
[]
[]
[]
[null,"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 Issuer 1 (Box 16)","Name of Issuer 1 (Box 16)","Name of Issuer 1 (Box 16)","Name of Issuer 1 (Box 16)","Name of Issuer 1 (Box 16)","Name of Issuer 1 (Box 16)",40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Name of Issuer 2 (Box 16)","Name of Issuer 2 (Box 16)","Name of Issuer 2 (Box 16)","Name of Issuer 2 (Box 16)","Name of Issuer 2 (Box 16)","Name of Issuer 2 (Box 16)",40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Issuer Address 1 (Box 19)","Issuer Address 1 (Box 19)","Issuer Address 1 (Box 19)","Issuer Address 1 (Box 19)","Issuer Address 1 (Box 19)","Issuer Address 1 (Box 19)",40,null,"A-Z, a-z, 0-9, hyphen, and forward slash"]
[null,null,null,"Issuer Address 2 (Box 19)","Issuer Address 2 (Box 19)","Issuer Address 2 (Box 19)","Issuer Address 2 (Box 19)","Issuer Address 2 (Box 19)","Issuer Address 2 (Box 19)",40,null,"A-Z, a-z, 0-9, hyphen, and forward slash"]
[null,null,null,"Issuer City (Box 20)","Issuer City (Box 20)","Issuer City (Box 20)","Issuer City (Box 20)","Issuer City (Box 20)","Issuer City (Box 20)",20,null,"A-Z and a-z"]
[null,null,null,"Issuer State (Box 21)","Issuer State (Box 21)","Issuer State (Box 21)","Issuer State (Box 21)","Issuer State (Box 21)","Issuer State (Box 21)",2,null,"State",null,null,"WI"]
[null,null,null,"Issuer Zip (Box 22)","Issuer Zip (Box 22)","Issuer Zip (Box 22)","Issuer Zip (Box 22)","Issuer Zip (Box 22)","Issuer Zip (Box 22)","5 or 9",null,"Numbers",null,null,"99999 or 999999999"]
[null,null,null,"Issuer Foreign Address Indicator","Issuer Foreign Address Indicator","Issuer Foreign Address Indicator","Issuer Foreign Address Indicator","Issuer Foreign Address Indicator","Issuer 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,"Issuer Foreign State Name (Box 21)","Issuer Foreign State Name (Box 21)","Issuer Foreign State Name (Box 21)","Issuer Foreign State Name (Box 21)","Issuer Foreign State Name (Box 21)","Issuer Foreign State Name (Box 21)",23,null,"A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe"]
[null,null,null,"Issuer Foreign Postal Code (Box 22)","Issuer Foreign Postal Code (Box 22)","Issuer Foreign Postal Code (Box 22)","Issuer Foreign Postal Code (Box 22)","Issuer Foreign Postal Code (Box 22)","Issuer Foreign Postal Code (Box 22)",15,null,"A-Z, a-z, 0-9, period, slash, and hyphen"]
[null,null,null,"Issuer Foreign Country Code (Box 22)","Issuer Country Code (Box 22)","Issuer Country Code (Box 22)","Issuer Country Code (Box 22)","Issuer Country Code (Box 22)","Issuer Country Code (Box 22)",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,"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,"1095 Contact Phone (Box 18)","1095 Contact Phone (Box 18)","1095 Contact Phone (Box 18)","1095 Contact Phone (Box 18)","1095 Contact Phone (Box 18)","1095 Contact Phone (Box 18)",15,null,"Numbers"]
[null,null,null,"1095 Contact Phone Ext (Box 18)","1095 Contact Phone Ext (Box 18)","1095 Contact Phone Ext (Box 18)","1095 Contact Phone Ext (Box 18)","1095 Contact Phone Ext (Box 18)","1095 Contact Phone Ext (Box 18)",5,null,"Numbers"]
[null,null,null,"Issuer Identification Number (Box 17)","Issuer Identification Number (Box 17)","Issuer Identification Number (Box 17)","Issuer Identification Number (Box 17)","Issuer Identification Number (Box 17)","Issuer Identification Number (Box 17)",9,null,"Numbers",null,null,999999999]
[null,null,null,"Issuer Misc Search One","Issuer Misc Search One","Issuer Misc Search One","Issuer Misc Search One","Issuer Misc Search One","Issuer Misc Search One",40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Issuer Misc Search Two","Issuer Misc Search Two","Issuer Misc Search Two","Issuer Misc Search Two","Issuer Misc Search Two","Issuer Misc Search Two",40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Name Of Sponsoring Employer 1 (Box 10)","Name Of Sponsoring Employer 1 (Box 10)","Name Of Sponsoring Employer 1 (Box 10)","Name Of Sponsoring Employer 1 (Box 10)","Name Of Sponsoring Employer 1 (Box 10)","Name Of Sponsoring Employer 1 (Box 10)",40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Name Of Sponsoring Employer 2 (Box 10)","Name Of Sponsoring Employer 2 (Box 10)","Name Of Sponsoring Employer 2 (Box 10)","Name Of Sponsoring Employer 2 (Box 10)","Name Of Sponsoring Employer 2 (Box 10)","Name Of Sponsoring Employer 2 (Box 10)",40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Sponsoring Employer Address 1 (Box 12)","Sponsoring Employer Address 1 (Box 12)","Sponsoring Employer Address 1 (Box 12)","Sponsoring Employer Address 1 (Box 12)","Sponsoring Employer Address 1 (Box 12)","Sponsoring Employer Address 1 (Box 12)",40,null,"A-Z, a-z, 0-9, hyphen, and forward slash"]
[null,null,null,"Sponsoring Employer Address 2 (Box 12)","Sponsoring Employer Address 2 (Box 12)","Sponsoring Employer Address 2 (Box 12)","Sponsoring Employer Address 2 (Box 12)","Sponsoring Employer Address 2 (Box 12)","Sponsoring Employer Address 2 (Box 12)",40,null,"A-Z, a-z, 0-9, hyphen, and forward slash"]
[null,null,null,"Sponsoring Employer City (Box 13)","Sponsoring Employer City (Box 13)","Sponsoring Employer City (Box 13)","Sponsoring Employer City (Box 13)","Sponsoring Employer City (Box 13)","Sponsoring Employer City (Box 13)",20,null,"A-Z and a-z"]
[null,null,null,"Sponsoring Employer State (Box 14)","Sponsoring Employer State (Box 14)","Sponsoring Employer State (Box 14)","Sponsoring Employer State (Box 14)","Sponsoring Employer State (Box 14)","Sponsoring Employer State (Box 14)",2,null,"State",null,null,"MI"]
[null,null,null,"Sponsoring Employer Zip (Box 15)","Sponsoring Employer Zip (Box 15)","Sponsoring Employer Zip (Box 15)","Sponsoring Employer Zip (Box 15)","Sponsoring Employer Zip (Box 15)","Sponsoring Employer Zip (Box 15)","5 or 9",null,"Numbers",null,null,"99999 or 999999999"]
[null,null,null,"Sponsoring Employer Foreign Address Indicator","Sponsoring Employer Foreign Address Indicator","Sponsoring Employer Foreign Address Indicator","Sponsoring Employer Foreign Address Indicator","Sponsoring Employer Foreign Address Indicator","Sponsoring 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,"Sponsoring Employer Foreign State Name (Box 14)","Sponsoring Employer Foreign State Name (Box 14)","Sponsoring Employer Foreign State Name (Box 14)","Sponsoring Employer Foreign State Name (Box 14)","Sponsoring Employer Foreign State Name (Box 14)","Sponsoring Employer Foreign State Name (Box 14)",23,null,"A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe"]
[null,null,null,"Sponsoring Employer Foreign Postal Code (Box 15)","Sponsoring Employer Foreign Postal Code (Box 15)","Sponsoring Employer Foreign Postal Code (Box 15)","Sponsoring Employer Foreign Postal Code (Box 15)","Sponsoring Employer Foreign Postal Code (Box 15)","Sponsoring Employer Foreign Postal Code (Box 15)",15,null,"A-Z, a-z, 0-9, period, slash, and hyphen"]
[null,null,null,"Sponsoring Employer Foreign Country Code (Box 15)","Sponsoring Employer Country Code (Box 15)","Sponsoring Employer Country Code (Box 15)","Sponsoring Employer Country Code (Box 15)","Sponsoring Employer Country Code (Box 15)","Sponsoring Employer Country Code (Box 15)",2,null,"Foreign Country Codes List"]
[null,null,null,"Sponsoring Employer Identification Number (Box 11)","Sponsoring Employer Identification Number (Box 11)","Sponsoring Employer Identification Number (Box 11)","Sponsoring Employer Identification Number (Box 11)","Sponsoring Employer Identification Number (Box 11)","Sponsoring Employer Identification Number (Box 11)",9,null,"Numbers",null,null,999999999]
[null,null,null,"Responsible Individual SSN Or TIN (Box 2)","Responsible Individual SSN Or TIN (Box 2)","Responsible Individual SSN Or TIN (Box 2)","Responsible Individual SSN Or TIN (Box 2)","Responsible Individual SSN Or TIN (Box 2)","Responsible Individual SSN Or TIN (Box 2)",9,null,"Numbers",null,null,999999999]
[null,null,null,"Responsible Individual Date Of Birth (Box 3)","Responsible Individual Date Of Birth (Box 3)","Responsible Individual Date Of Birth (Box 3)","Responsible Individual Date Of Birth (Box 3)","Responsible Individual Date Of Birth (Box 3)","Responsible Individual Date Of Birth (Box 3)",10,null,"Numbers and slashes",null,null,"99/99/9999"]
[null,null,null,"Responsible Individual First Name (Box 1)","Responsible Individual First Name (Box 1)","Responsible Individual First Name (Box 1)","Responsible Individual First Name (Box 1)","Responsible Individual First Name (Box 1)","Responsible Individual First Name (Box 1)",15,null,"A-Z, a-z, and hyphen"]
[null,null,null,"Responsible Individual Middle Initial (Box 1)","Responsible Individual Middle Initial (Box 1)","Responsible Individual Middle Initial (Box 1)","Responsible Individual Middle Initial (Box 1)","Responsible Individual Middle Initial (Box 1)","Responsible Individual Middle Initial (Box 1)",1,null,"A-Z, a-z, and hyphen"]
[null,null,null,"Responsible Individual Last Name (Box 1)","Responsible Individual Last Name (Box 1)","Responsible Individual Last Name (Box 1)","Responsible Individual Last Name (Box 1)","Responsible Individual Last Name (Box 1)","Responsible Individual Last Name (Box 1)",20,null,"A-Z, a-z, and hyphen"]
[null,null,null,"Responsible Individual Suffix (Box 1)","Responsible Individual Suffix (Box 1)","Responsible Individual Suffix (Box 1)","Responsible Individual Suffix (Box 1)","Responsible Individual Suffix (Box 1)","Responsible Individual Suffix (Box 1)",4,null,"A-Z, a-z, and hyphen"]
[null,null,null,"Responsible Individual Address 1 (Box 4)","Responsible Individual Address 1 (Box 4)","Responsible Individual Address 1 (Box 4)","Responsible Individual Address 1 (Box 4)","Responsible Individual Address 1 (Box 4)","Responsible Individual Address 1 (Box 4)",40,null,"A-Z, a-z, 0-9, hyphen, and forward slash"]
[null,null,null,"Responsible Individual Address 2 (Box 4)","Responsible Individual Address 2 (Box 4)","Responsible Individual Address 2 (Box 4)","Responsible Individual Address 2 (Box 4)","Responsible Individual Address 2 (Box 4)","Responsible Individual Address 2 (Box 4)",40,null,"A-Z, a-z, 0-9, hyphen, and forward slash"]
[null,null,null,"Responsible Individual City (Box 5)","Responsible Individual City (Box 5)","Responsible Individual City (Box 5)","Responsible Individual City (Box 5)","Responsible Individual City (Box 5)","Responsible Individual City (Box 5)",20,null,"A-Z and a-z"]
[null,null,null,"Responsible Individual State (Box 6)","Responsible Individual State (Box 6)","Responsible Individual State (Box 6)","Responsible Individual State (Box 6)","Responsible Individual State (Box 6)","Responsible Individual State (Box 6)",2,null,"State",null,null,"WI"]
[null,null,null,"Responsible Individual Zip (Box 7)","Responsible Individual Zip (Box 7)","Responsible Individual Zip (Box 7)","Responsible Individual Zip (Box 7)","Responsible Individual Zip (Box 7)","Responsible Individual Zip (Box 7)","5 or 9",null,"Numbers",null,null,"99999 or 999999999"]
[null,null,null,"Responsible Individual Foreign Address Indicator","Responsible Individual Foreign Address Indicator","Responsible Individual Foreign Address Indicator","Responsible Individual Foreign Address Indicator","Responsible Individual Foreign Address Indicator","Responsible Individual 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,"Responsible Individual Foreign State Name (Box 6)","Responsible Individual Foreign State Name (Box 6)","Responsible Individual Foreign State Name (Box 6)","Responsible Individual Foreign State Name (Box 6)","Responsible Individual Foreign State Name (Box 6)","Responsible Individual Foreign State Name (Box 6)",23,null,"A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe"]
[null,null,null,"Responsible Individual Foreign Postal Code (Box 7)","Responsible Individual Foreign Postal Code (Box 7)","Responsible Individual Foreign Postal Code (Box 7)","Responsible Individual Foreign Postal Code (Box 7)","Responsible Individual Foreign Postal Code (Box 7)","Responsible Individual Foreign Postal Code (Box 7)",15,null,"A-Z, a-z, 0-9, period, slash, and hyphen"]
[null,null,null,"Responsible Individual Foreign Country Code (Box 7)","Responsible Individual Country Code (Box 7)","Responsible Individual Country Code (Box 7)","Responsible Individual Country Code (Box 7)","Responsible Individual Country Code (Box 7)","Responsible Individual Country Code (Box 7)",2,null,"Foreign Country Codes List"]
[null,null,null,"Responsible Individual Email (Online Retrieval)","Responsible Individual Email (Online Retrieval)","Responsible Individual Email (Online Retrieval)","Responsible Individual Email (Online Retrieval)","Responsible Individual Email (Online Retrieval)","Responsible Individual Email (Online Retrieval)",75,null,"A-Z, a-z, 0-9, !, #, $, %, &, ', *, +, /, =, ?, ^, _ , `, {, |, }, ~,-, ., and @",null,null,"Required for Online Retrieval"]
[null,null,null,"Responsible Individual Misc Search","Responsible Individual Misc Search","Responsible Individual Misc Search","Responsible Individual Misc Search","Responsible Individual Misc Search","Responsible Individual Misc Search",40,null,"A-Z, a-z, 0-9, hash, hyphen, ampersand, parens, apostrophes, and period"]
[null,null,null,"Origin Of Health Coverage","Origin Of Health Coverage","Origin Of Health Coverage","Origin Of Health Coverage","Origin Of Health Coverage","Origin Of Health Coverage",1,null,"Origin of Health Coverage",null,null,"A - Small Business Health Options Program (SHOP)\n B - Employer-sponsored coverage\n C - Government-sponsored program\n D - Individual market insurance\n E - Multiemployer plan\n F - Other designated minimum essential coverage\nG - Employer-sponsored coverage that is an individual coverage HRA"]
[null,null,null,"Individual SSN Or TIN (b1) Through Individual SSN Or TIN (b25)","Individual SSN Or TIN (b1) Through Individual SSN Or TIN (b25)","Individual SSN Or TIN (b1) Through Individual SSN Or TIN (b25)","Individual SSN Or TIN (b1) Through Individual SSN Or TIN (b25)","Individual SSN Or TIN (b1) Through Individual SSN Or TIN (b25)","Individual SSN Or TIN (b1) Through Individual SSN Or TIN (b25)",9,null,"Numbers",null,null,999999999]
[null,null,null,"DOB (c1) Through DOB (c25)","DOB (c1) Through DOB (c25)","DOB (c1) Through DOB (c25)","DOB (c1) Through DOB (c25)","DOB (c1) Through DOB (c25)","DOB (c1) Through DOB (c25)",10,null,"Numbers and slashes",null,null,"99/99/9999"]
[null,null,null,"First Name (a1) Through First Name (a25)","First Name (a1) Through First Name (a25)","First Name (a1) Through First Name (a25)","First Name (a1) Through First Name (a25)","First Name (a1) Through First Name (a25)","First Name (a1) Through First Name (a25)",15,null,"A-Z, a-z, and hyphen"]
[null,null,null,"Middle Initial (a1) Through Middle Initial (a25)","Middle Initial (a1) Through Middle Initial (a25)","Middle Initial (a1) Through Middle Initial (a25)","Middle Initial (a1) Through Middle Initial (a25)","Middle Initial (a1) Through Middle Initial (a25)","Middle Initial (a1) Through Middle Initial (a25)",1,null,"A-Z, a-z, and hyphen"]
[null,null,null,"Last Name (a1) Through Last Name (a25)","Last Name (a1) Through Last Name (a25)","Last Name (a1) Through Last Name (a25)","Last Name (a1) Through Last Name (a25)","Last Name (a1) Through Last Name (a25)","Last Name (a1) Through Last Name (a25)",20,null,"A-Z, a-z, and hyphen"]
[null,null,null,"Suffix (a1) Through Suffix (a25)","Suffix (a1) Through Suffix (a25)","Suffix (a1) Through Suffix (a25)","Suffix (a1) Through Suffix (a25)","Suffix (a1) Through Suffix (a25)","Suffix (a1) Through Suffix (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) Through Covered 12 Months (a25)","Covered 12 Months (d1) Through Covered 12 Months (a25)","Covered 12 Months (d1) Through Covered 12 Months (a25)","Covered 12 Months (d1) Through Covered 12 Months (a25)","Covered 12 Months (d1) Through Covered 12 Months (a25)",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,"Jan (e1) Through Jan (e25)","Jan (e1) Through Jan (e25)","Jan (e1) Through Jan (e25)","Jan (e1) Through Jan (e25)","Jan (e1) Through Jan (e25)","Jan (e1) Through Jan (e25)",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,"Feb (e1) Through Feb (e25)","Feb (e1) Through Feb (e25)","Feb (e1) Through Feb (e25)","Feb (e1) Through Feb (e25)","Feb (e1) Through Feb (e25)","Feb (e1) Through Feb (e25)",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,"Mar (e1) Through Mar (e25)","Mar (e1) Through Mar (e25)","Mar (e1) Through Mar (e25)","Mar (e1) Through Mar (e25)","Mar (e1) Through Mar (e25)","Mar (e1) Through Mar (e25)",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,"Apr (e1) Through (e25)","Apr (e1) Through (e25)","Apr (e1) Through (e25)","Apr (e1) Through (e25)","Apr (e1) Through (e25)","Apr (e1) Through (e25)",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,"May (e1) Through May (e25)","May (e1) Through May (e25)","May (e1) Through May (e25)","May (e1) Through May (e25)","May (e1) Through May (e25)","May (e1) Through May (e25)",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,"Jun (e1) Through Jun (e25)","Jun (e1) Through Jun (e25)","Jun (e1) Through Jun (e25)","Jun (e1) Through Jun (e25)","Jun (e1) Through Jun (e25)","Jun (e1) Through Jun (e25)",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,"Jul (e1) Through Jul (e25)","Jul (e1) Through Jul (e25)","Jul (e1) Through Jul (e25)","Jul (e1) Through Jul (e25)","Jul (e1) Through Jul (e25)","Jul (e1) Through Jul (e25)",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,"Aug (e1) Through Aug (e25)","Aug (e1) Through Aug (e25)","Aug (e1) Through Aug (e25)","Aug (e1) Through Aug (e25)","Aug (e1) Through Aug (e25)","Aug (e1) Through Aug (e25)",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,"Sep (e1) Through Sep (e25)","Sep (e1) Through Sep (e25)","Sep (e1) Through Sep (e25)","Sep (e1) Through Sep (e25)","Sep (e1) Through Sep (e25)","Sep (e1) Through Sep (e25)",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,"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)","Oct (e1) Through Oct (e25)",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,"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, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
[null,null,null,"Dec (e1) Through Dec (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, or t to check box \n0, False, f or blank to not check the box \n (upper or lower case)"]
[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",null,null,null,null,null,8,null,"CA, DC, NJ and/or RI"]

{"sheet":"Field Length And Format","index":4,"n_rows":74,"n_cols":7,"rows_kept":74,"cut":false,"hidden":true,"merged":[]}
["Field Name","Field Name","Maximum Length","Characters Allowed","Display Characters Allowed","Characters to Trim","Format"]
["Name of Issuer 1 (Box 16)","Name of Issuer 1 (Box 16)",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 Issuer 2 (Box 16)","Name of Issuer 2 (Box 16)",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"]
["Issuer Address 1 (Box 19)","Issuer Address 1 (Box 19)",40,"A-Z, a-z, 0-9, hyphen, and forward slash","A-Z, a-z, 0-9, hyphen, and forward slash"]
["Issuer Address 2 (Box 19)","Issuer Address 2 (Box 19)",40,"A-Z, a-z, 0-9, hyphen, and forward slash","A-Z, a-z, 0-9, hyphen, and forward slash"]
["Issuer City (Box 20)","Issuer City (Box 20)",20,"A-Z and a-z","A-Z and a-z"]
["Issuer State (Box 21)","Issuer State (Box 21)",2,"State","State Abbreviations",null,"WI"]
["Issuer Zip (Box 22)","Issuer Zip (Box 22)","5 or 9","Numbers","Numbers","Hyphens","99999 or 999999999"]
["Issuer Foreign Address Indicator","Issuer 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)"]
["Issuer Foreign State Name (Box 21)","Issuer Foreign State Name (Box 21)",23,"A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe","A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe"]
["Issuer Foreign Postal Code (Box 22)","Issuer Foreign Postal Code (Box 22)",15,"A-Z, a-z, 0-9, period, slash, and hyphen","A-Z, a-z, 0-9, period, slash, and hyphen"]
["Issuer Foreign Country Code (Box 22)","Issuer Foreign Country Code (Box 22)",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"]
["1094 Contact Phone","1094 Contact Phone",15,"Numbers","Numbers","Parentheses, spaces, and hyphens"]
["1094 Contact Phone Ext","1094 Contact Phone Ext",4,"Numbers","Numbers"]
["1095 Contact Phone (Box 18)","1095 Contact Phone (Box 18)",15,"Numbers","Numbers","Parentheses, spaces, and hyphens"]
["1095 Contact Phone Ext (Box 18)","1095 Contact Phone Ext (Box 18)",4,"Numbers","Numbers"]
["Issuer Identification Number (Box 17)","Issuer Identification Number (Box 17)",9,"Numbers","Numbers","Hyphens",999999999]
["Issuer Misc Search One","Issuer 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"]
["Issuer Misc Search Two","Issuer 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"]
["Name Of Sponsoring Employer 1 (Box 10)","Name Of Sponsoring Employer 1 (Box 10)",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 Sponsoring Employer 2 (Box 10)","Name Of Sponsoring Employer 2 (Box 10)",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"]
["Sponsoring Employer Address 1 (Box 12)","Sponsoring Employer Address 1 (Box 12)",40,"A-Z, a-z, 0-9, hyphen, and forward slash","A-Z, a-z, 0-9, hyphen, and forward slash"]
["Sponsoring Employer Address 2 (Box 12)","Sponsoring Employer Address 2 (Box 12)",40,"A-Z, a-z, 0-9, hyphen, and forward slash","A-Z, a-z, 0-9, hyphen, and forward slash"]
["Sponsoring Employer City (Box 13)","Sponsoring Employer City (Box 13)",20,"A-Z and a-z","A-Z and a-z"]
["Sponsoring Employer State (Box 14)","Sponsoring Employer State (Box 14)",2,"State","State Abbreviations",null,"MI"]
["Sponsoring Employer Zip (Box 15)","Sponsoring Employer Zip (Box 15)","5 or 9","Numbers","Numbers","Hyphens","99999 or 999999999"]
["Sponsoring Employer Foreign Address Indicator","Sponsoring 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)"]
["Sponsoring Employer Foreign State Name (Box 14)","Sponsoring Employer Foreign State Name (Box 14)",23,"A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe","A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe"]
["Sponsoring Employer Foreign Postal Code (Box 15)","Sponsoring Employer Foreign Postal Code (Box 15)",15,"A-Z, a-z, 0-9, period, slash, and hyphen","A-Z, a-z, 0-9, period, slash, and hyphen"]
["Sponsoring Employer Foreign Country Code (Box 15)","Sponsoring Employer Foreign Country Code (Box 15)",2,"Foreign Country Codes List","Foreign Country Codes List"]
["Sponsoring Employer Identification Number (Box 11)","Sponsoring Employer Identification Number (Box 11)",9,"Numbers","Numbers","Hyphens",999999999]
["Responsible Individual SSN Or TIN (Box 2)","Responsible Individual SSN Or TIN (Box 2)",9,"Numbers","Numbers","Hyphens",999999999]
["Responsible Individual Date Of Birth (Box 3)","Responsible Individual Date Of Birth (Box 3)",10,"Numbers and slashes","Numbers and slashes",null,"99/99/9999"]
["Responsible Individual First Name (Box 1)","Responsible Individual First Name (Box 1)",12,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["Responsible Individual Middle Initial (Box 1)","Responsible Individual Middle Initial (Box 1)",1,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["Responsible Individual Last Name (Box 1)","Responsible Individual Last Name (Box 1)",20,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["Responsible Individual Suffix (Box 1)","Responsible Individual Suffix (Box 1)",4,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["Responsible Individual Address 1 (Box 4)","Responsible Individual Address 1 (Box 4)",40,"A-Z, a-z, 0-9, hyphen, and forward slash","A-Z, a-z, 0-9, hyphen, and forward slash"]
["Responsible Individual Address 2 (Box 4)","Responsible Individual Address 2 (Box 4)",40,"A-Z, a-z, 0-9, hyphen, and forward slash","A-Z, a-z, 0-9, hyphen, and forward slash"]
["Responsible Individual City (Box 5)","Responsible Individual City (Box 5)",20,"A-Z and a-z","A-Z and a-z"]
["Responsible Individual State (Box 6)","Responsible Individual State (Box 6)",2,"State","State Abbreviations",null,"WI"]
["Responsible Individual Zip (Box 7)","Responsible Individual Zip (Box 7)","5 or 9","Numbers","Numbers","Hyphens","99999 or 999999999"]
["Responsible Individual Foreign Address Indicator","Responsible Individual 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)"]
["Responsible Individual Foreign State Name (Box 6)","Responsible Individual Foreign State Name (Box 6)",23,"A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe","A-Z, a-z, 0-9, period, slash, hyphen, and apostrophe"]
["Responsible Individual Foreign Postal Code (Box 7)","Responsible Individual Foreign Postal Code (Box 7)",15,"A-Z, a-z, 0-9, period, slash, and hyphen","A-Z, a-z, 0-9, period, slash, and hyphen"]
["Responsible Individual Foreign Country Code (Box 7)","Responsible Individual Foreign Country Code (Box 7)",2,"Foreign Country Codes List","Foreign Country Codes List"]
["Responsible Individual Email (Online Retrieval)","Responsible Individual Email (Online Retrieval)",75,"A-Z, a-z, 0-9, !, #, $, %, &, ', *, +, /, =, ?, ^, _ , `, {, |, }, ~,-, ., and @","A-Z, a-z, 0-9, !, #, $, %, &, ', *, +, /, =, ?, ^, _ , `, {, |, }, ~,-, ., and @",null,"Responsibleindividual@domain.com"]
["Responsible Individual Misc Search","Responsible Individual 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"]
["Origin Of Health Coverage","Origin Of Health Coverage",1,"Orgin of Health Coverage","Orgin of Health Coverage: A, B, C, D, E, F or G",null,"A - Small Business Health Options Program (SHOP)\n B - Employer-sponsored coverage\n C - Government-sponsored program\n D - Individual market insurance\n E - Multiemployer plan\n F - Other designated minimum essential coverage\nG - Employer-sponsored coverage that is an individual coverage HRA "]
["Individual SSN Or TIN (b1) Through Individual SSN Or TIN (b25)","Individual SSN Or TIN (b*",9,"Numbers","Numbers","Hyphens",999999999]
["DOB (c1) Through DOB (c25)","DOB (c*",10,"Numbers and slashes","Numbers and slashes",null,"99/99/9999"]
["First Name (a1) Through First Name (a25)","First Name (a*",12,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["Middle Initial (a1) Through Middle Initial (a25)","Middle Initial (a*",1,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["Last Name (a1) Through Last Name (a25)","Last Name (a*",20,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["Suffix (a1) Through Suffix (a25)","Suffix (a*",4,"A-Z, a-z, and hyphen","A-Z, a-z, and hyphen","Comma, ampersands"]
["Covered 12 Months (d1) Through Covered 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)"]
["Jan (e1) Through Jan (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)"]
["Feb (e1) Through Feb (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)"]
["Mar (e1) Through Mar (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)"]
["Apr (e1) Through (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)"]
["May (e1) Through May (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)"]
["Jun (e1) Through Jun (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)"]
["Jul (e1) Through Jul (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)"]
["Aug (e1) Through Aug (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)"]
["Sep (e1) Through Sep (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)"]
["Oct (e1) Through Oct (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)"]
["Nov (e1) Through Nov (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)"]
["Dec (e1) Through Dec (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)"]
["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":5,"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"]