Employer Data

							                                                                        Termination File Record LAyout



FEIN - 9 digits             Employer Name - max 50                                        Employer Phone Extension - 4   Contact Person - max 30
(required field)            characters (required field)   Employer Phone - 10 digits      digits                         characters (required field)




Enter Record #1 here. This record contains your EMPLOYER data.




                                                                                                                         Employee Date of Termination -
Employee First Name - max 16 Employee Middle Name - max 4 Employee Last Name - max 30     Employee SSN - 9 digits        YYYYMMDD format
characters (required field)  characters (optional field)  characters (required field)     (required field)               (required field)




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                                                                       Termination File Record LAyout




NCP Forwarding Address1 if   NCP Forwarding Address 2 if   NCP Forwarding City if Known -   NCP Forwarding State if Known - 2   NCP Forwarding Zip if Known -
Known - max 50 characters    Known - max 50 characters     Up to 30 characters              characters                          max 9 digits




        d5788ec0-ba6d-497e-a8bc-ce1a6b76221c.xls                                  Page 2 of 3
                                           Termination File Record LAyout




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