EDI 153 Unemployment Insurance Tax Claim or Charge Information

Functional Group CB

X12F Finance Subcommittee

This Draft Standard for Trial Use contains the format and establishes the data contents of the Unemployment Insurance Tax Claim or Charge Information Transaction Set (153) for use within the context of an Electronic Data Interchange (EDI) environment. This bi-directional transaction set can be used by employment security agencies to notify employers or other agencies of a possible charge to their employers' unemployment insurance tax account and by employers responding to the notice with supplemental information that might affect the chargeability of the claim. This transaction set can also be used by employers to notify claimant(s)' representative, e.g., union, to protest a claim.

Heading

1. 010 · ST · Transaction Set Header · Max 1 · Mandatory

   To indicate the start of a transaction set and to assign a control number

2. 020 · BTI · Beginning Tax Information · Max 1 · Mandatory

   To indicate the type of tax information

3. N1 Loop Mandatory Repeat >1

   1. 030 · N1 · Name · Max 1 · Mandatory

      To identify a party by type of organization, name, and code

      This N1 segment must identify the employer and may also identify the issuing agency, the employer's representative or the claimant's(s') representative.

   2. 040 · N2 · Additional Name Information · Max 1 · Optional

      To specify additional names or those longer than 35 characters in length

   3. 050 · N3 · Address Information · Max 1 · Optional

      To specify the location of the named party

   4. 060 · N4 · Geographic Location · Max 1 · Optional

      To specify the geographic place of the named party

   5. 070 · REF · Reference Identification · Max >1 · Optional

      To specify identifying information

      This REF segment identifies an employer's successor/predecessor account identification.

   6. 080 · AMT · Monetary Amount · Max >1 · Optional

      To indicate the total monetary amount

   7. 090 · PCT · Percent Amounts · Max >1 · Optional

      To qualify percent amounts and supply percent amounts

   8. 100 · CHB · Chargeback Information · Max >1 · Optional

      To define elements associated with a charge to unemployment insurance tax account

   9. 110 · DTM · Date/Time Reference · Max >1 · Optional

      To specify pertinent dates and times

   10. 120 · PER · Administrative Communications Contact · Max >1 · Optional

       To identify a person or office to whom administrative communications should be directed

Detail

1. NM1 Loop Mandatory Repeat >1

   1. 010 · NM1 · Individual or Organizational Name · Max 1 · Mandatory

      To supply the full name of an individual or organizational entity

      This NM1 loop identifies a claimant.

   2. 020 · DPN · Dependent Information · Max >1 · Optional

      To provide dependent information

   3. 030 · REF · Reference Identification · Max >1 · Optional

      To specify identifying information

      This REF segment is used for the claim number or change to the Social Security Number.

   4. 040 · AMT · Monetary Amount · Max >1 · Optional

      To indicate the total monetary amount

   5. 050 · PCT · Percent Amounts · Max >1 · Optional

      To qualify percent amounts and supply percent amounts

   6. 060 · CHB · Chargeback Information · Max >1 · Optional

      To define elements associated with a charge to unemployment insurance tax account

   7. 070 · DTM · Date/Time Reference · Max >1 · Optional

      To specify pertinent dates and times

   8. 080 · MSG · Message Text · Max >1 · Optional

      To provide a free-form format that allows the transmission of text information

   9. PAM Loop Optional Repeat >1

      1. 090 · PAM · Period Amount · Max 1 · Mandatory

         To indicate a quantity, and/or amount for an identified period

         This PAM loop reflects wages and/or compensation paid.

      2. 100 · REF · Reference Identification · Max >1 · Optional

         To specify identifying information

         This REF segment further identifies this wage item.

      3. 110 · CHB · Chargeback Information · Max >1 · Optional

         To define elements associated with a charge to unemployment insurance tax account

2. 120 · SE · Transaction Set Trailer · Max 1 · Mandatory

   To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments)