Sample File = Schema\2022\TEXT\T99R.txt String fields are displayed within quotations CRLF=Carriage Return Line Feed (Hex 0D0A)
"Street address line 1" "Street address line 2" "City" "State" "Zip code" "Foreign address indicator" ¹ "Foreign city, province, postal code, etc." "TIN Type" "Date of payment" º "Taxable amount not determined" ¹ "Total distribution indicator" ¹ Gross distribution Taxable amount Capital gain included in the taxable amount above Federal income tax withheld Employee contributions or insurance premiums Net unrealized appreciation in employer's securities Other % ² Your percentage of total distribution ² Total employee contributions Amount allocable to IRR within 5 years "First year of designated Roth contribution" ³ "FATCA filing requirement indicator" ¹ "State #1" State #1 tax withheld State #1 distribution Locality #1 tax withheld Locality #1 distribution "Name of Locality #1" "State #2" State #2 tax withheld State #2 distribution Locality #2 tax withheld Locality #2 distribution "Name of Locality #2" "E-Mail address" CRLF
º Use format MMDDYYYY or MMDDYY (21st century is assumed) ¹ "X" if applicable, otherwise, enter a null string "" ² Enter as a whole number between 0 and 100 ³ Enter as a 4-digit year or leave null ""
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