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

Position
Segment
Name
Max use
0100
Transaction Set HeaderMandatory
Max 1
To indicate the start of a transaction set and to assign a control number
0200
Beginning Tax InformationMandatory
Max 1
To indicate the type of tax information
N1 Loop
Repeat >1
0300
NameMandatory
Max 1
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.
0500
Address InformationOptional
Max 1
To specify the location of the named party
0600
Geographic LocationOptional
Max 1
To specify the geographic place of the named party
0700
Reference IdentificationOptional
Max >1
To specify identifying information
This REF segment identifies an employer's successor/predecessor account identification.
0800
Monetary AmountOptional
Max >1
To indicate the total monetary amount
0900
Percent AmountsOptional
Max >1
To qualify percent amounts and supply percent amounts
1000
Chargeback InformationOptional
Max >1
To define elements associated with a charge to unemployment insurance tax account
1100
Date/Time ReferenceOptional
Max >1
To specify pertinent dates and times
1200
Administrative Communications ContactOptional
Max >1
To identify a person or office to whom administrative communications should be directed

Detail

Position
Segment
Name
Max use
NM1 Loop
Repeat >1
0100
Individual or Organizational NameMandatory
Max 1
To supply the full name of an individual or organizational entity
This NM1 loop identifies a claimant.
0200
Dependent InformationOptional
Max >1
To provide dependent information
0300
Reference IdentificationOptional
Max >1
To specify identifying information
This REF segment is used for the claim number or change to the Social Security Number.
0400
Monetary AmountOptional
Max >1
To indicate the total monetary amount
0500
Percent AmountsOptional
Max >1
To qualify percent amounts and supply percent amounts
0600
Chargeback InformationOptional
Max >1
To define elements associated with a charge to unemployment insurance tax account
0700
Date/Time ReferenceOptional
Max >1
To specify pertinent dates and times
0800
Message TextOptional
Max >1
To provide a free-form format that allows the transmission of text information
PAM Loop
Repeat >1
0900
Period AmountMandatory
Max 1
To indicate a quantity, and/or amount for an identified period
This PAM loop reflects wages and/or compensation paid.
1000
Reference IdentificationOptional
Max >1
To specify identifying information
This REF segment further identifies this wage item.
1100
Chargeback InformationOptional
Max >1
To define elements associated with a charge to unemployment insurance tax account
1200
Transaction Set TrailerMandatory
Max 1
To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments)

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