Interstate Output Record Format (Effective in December 2008) Note: If the option/mandatory column is followed by one or more “+” or a “*”, the bottom of this webpage provides for further explanation. Record Element Name Element Position Element Description/Definition Optional Mandatory Definition Client SSN 1-9 Client's Social Security Number M Self-explanatory Client Surname 10-24 Client's Last Name M Self-explanatory Client First Name 25-39 Client's First Name M Self-explanatory Client Date of Birth 40-47 Client Date of Birth (CCYYMMDD) M Self-explanatory filler 48 Blank M Self-explanatory File Date 49-54 Match Run Month (CCYYMM) M State Name 55-56 Postal Abbreviation for the State M Self-explanatory
State Optional Data 57-116 Data for the sending state’s use, returned as sent. O Client Locator Code 117-119 3 position location code that identifies Client Case File Residence (County/Local Office designator) M Self-explanatory Case Number 120-129 Ten Position Case Number M Self-explanatory Contact Supported: Phone 130 ‘Y’ if contact by voice phone is supported for follow up purposes, else ‘N’ M+ Type of contact to be used based on state requirement Contact Supported: Fax 131 ‘Y’ if contact by fax machine is supported for follow up purposes, else ‘N’ M+ Type of contact to be used based on state requirement Contact Supported: E-mail 132 ‘Y’ if contact by e-mail is supported for follow up purposes, else ‘N’ M+ Type of contact to be used based on state requirement
Contact Person Phone Number 133-142 10 Digit Telephone Number of Contact Person for investigation purposes M++ Central or county/region contact on state requirement Contact Person Phone Number Extension 143-147 up to 5 Digit Telephone Number extension of Contact Person for investigation purposes (if needed) O++ Fill with SPACES if not needed Contact Person Fax Number 148-157 Fax Number for Contact Person M++ Contact Person Email Address 158-197 Email Address of State Contact Person M++ SSN Verification Indicator 198 See bottom of this document for a list of SSA SVES Verification Indicator Codes M Whether the SSN has been verified by SSA TANF Months Eligibility 199-200 Number of Countable Months Client has received TANF Benefits as an O ***
Cash Last Paid Amount 201-204 Last Monthly Amount Paid Under a Cash Program (Drop Cents) such as TANF, General Assistance, State Admin SSI, etc O FS Last Paid Amount 205-208 Last Monthly Amount Paid Under Food Stamps O Last EBT Access Date 209-216 Last Date EBT Benefits Were Accessed (CCYYMMDD) Could be Any Assistance Program O Fraud Indicator 217 'Y' = Fraudulent Receipt of TANF Benefits, within Last Ten Due to Misrepresentation of Residence O Self-explanatory *** Fugitive Felon Indicator 218 'Y' = Current Fugitive Felon O Self-explanatory *** Probation and Parole Violation Indicator 219 'Y' = Current Probation or Parole Violation O Self-explanatory ***
Drug Related Felon Indicator 220 'Y' = Drug Related O Self-explanatory *** Address (Line 1) 221-245 Client Address (street line 1) M Self-explanatory Address (Line 2) 246-270 Client Address (street line 2, if needed) M Self-explanatory Address (City) 271-285 Client Address M Self-explanatory Address 286-287 Client Address M Self-explanatory Address (Zip Code) 288-296 Client Address M Self-explanatory Gender 297 M = Male, F = Female, U = Unknown M Self-explanatory Marital Status 298 M = Married, S = Single, W = widow/widower, D = Divorced, L = Separated, U = Unavailable or Unknown O Self-explanatory
VA Match Request Code 299 Y = Perform VA Match, N = No VA Match M +++ Self-explanatory State Match Request Code 300 Y = Perform Interstate Match, N = No State Match M +++ FED Match Request Code 301 Y = Perform Federal Data Match, N = No Fed Match M +++ Filler 302-315 All Blanks (for future use) M TANF Indicator 316 ‘Y’ = Client Receives TANF Assistance or their Assets Count O At least one of these must be ‘Y’ otherwise the individual should not be on the file. General Assistance Indicator 317 ‘Y’ = Client Receives GA or their Assets Count O At least one of these must be ‘Y’ otherwise the individual should not be on the file.
Food Indicator 318 ‘Y’ = Client Receives FS or their Assets Count O At least one of these must be ‘Y’ otherwise the individual should not be on the file. SSI Indicator 319 ‘Y’ = Client Receives SSI or their Assets Count O At one of these must be ‘Y’ otherwise the individual should not be on the file. Medicaid Indicator 320 ‘Y’ = Client on Medicaid or their Assets Count O At one of these must be ‘Y’ otherwise the individual should not be on the file. Child Care Indicator 321 ‘C’ = Record is for Receiving Child Assistance ‘P’ = Record is for Parent Receiving Child Care Assistance ‘R’ = Record is for a Child Care Provider O Worker’s Comp Indicator 322 ‘Y’ = Client Receives Worker’s Compensation O At least one of these must be ‘Y’ otherwise the individual should not be on the file.
Filler 323-329 All Blanks (for future use) M TANF Elig. Date 330-337 TANF Client Eligibility Start Date (CCYYMMDD) O * TANF Elig. End Date 338-345 TANF Client Eligibility End Date (CCYYMMDD) O ** Medicaid Elig. Start Date 346-353 Medicaid Client Eligibility Date (CCYYMMDD) O * Medicaid Elig. End Date 354-361 Medicaid Client Eligibility End Date (CCYYMMDD) O ** Food Stamps Eligibility Start Date 362-369 Food Stamps Client Eligibility Start Date (CCYYMMDD) O * Food Stamps Eligibility End Date 370-377 Food Stamps Client Eligibility End Date (CCYYMMDD) O **
Gen. Assist. Eligibility Start Date 378-385 GA Client Eligibility Start Date (CCYYMMDD) O * Gen. Assist. Eligibility End Date 386-393 GA Client Eligibility End Date (CCYYMMDD) O ** SSI Elig. Start Date 394-401 SSI Client Eligibility Start Date (CCYYMMDD) O * SSI Elig. End Date 402-409 SSI Client Eligibility End Date (CCYYMMDD) O ** Child Care Elig Start Date 410-417 Care Eligibility Start Date (CCYYMMDD) O * Child Care Elig End Date 418-425 Child Care Eligibility End Date (CCYYMMDD) O ** Worker’s Comp Elig Start Date 426-433 Worker’s Comp Eligibility Start Date (CCYYMMDD) O *