Version: 2021.07.15 | |||||||||||||
Template Name: Participant Household Payment Data | |||||||||||||
Instructions to Reporter: - Do not change the cell formatting - Do not reformat the template - All data should be as text - Do not publish the "Field ID" row (Treasury Internal Use Only) |
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Label | Address Line 1 | Address Line 2 | Address Line 3 | City Name | State Code | Zip5 | Zip4 | Payee Type | Amount of Payment | Date of Payment | Type of Assistance Covered by the payment | Start Date Covered by the Payment | End Date Covered by the Payment |
Required or Optional | Required | Optional | Optional | Required | Required | Required | Required | Required | Required | Required | Required | Required | Required |
Help Text | Record the first line of the Payee's physical address. | Second line of Payee's physical address. | Third line of the Payee's physical address. | Name of the city in which the Payee address is located. | Report the United States Postal Service (USPS) two-letter abbreviation for the state or territory in which the Payee address is located. Valid Responses: (AL, AK, AS, AZ, AR, CA, CO, CT, DE, DC, FM, FL, GA, GU, HI, ID, IL, IN, IA, KS, KY, LA, ME, MH, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, MP, OH, OK, OR, PW, PA, PR, RI, SC, SD, TN, TX, UT, VT, VI, VA, WA, WV, WI, WY) | Report the United States ZIP code (five digits) concatenated with the additional +4 digits associated with the Payee's physical address. Format XXXXX, 5 numeric characters. |
Zip Plus4 (four digits) identifying where the physical address of the payee. Format XXXX, 4 numeric characters. | Select the drop down correlating to the type of Payee. Select one of the following: '|- Tenant |- Landlord or Owner |- Utility / Home Energy Service Provider |- Other Housing Services and Eligible Expenses Provider |
Report the total amount dispersed to the Payee. DO NOT INCLUDE $ sign when entering amount. |
Report the date which payment was processed to Payee. Formatt MMDDYYYY | Select the drop down correlating to the type of assistance. Select one of the following: '- Financial Assistance: Rent; - Financial Assistance: Rental Arrears; - Financial Assistance: Utility/Home Energy Costs; - Financial Assistance: Utility/Home Energy Costs Arrears; - Financial Assistance: Other Housing Costs Incurred due to Covid-19; |
Report the start date indicating the time period covered by the assistance. Format MMDDYYYY | Report the end date indicating the time period covered by the assistance. Format MMDDYYYY |
File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |