3.12.12 Exempt Organization Returns

Manual Transmittal

December 07, 2016

Purpose

(1) This transmits revised IRM 3.12.12, Exempt Organization Returns Error Resolution, in Section 3.12.

Background

The instructions in this IRM are used for correcting errors made by taxpayers as well as those made by Submission Processing Center operations. Exempt Organization (EO) processing is centralized at the Ogden IRS Campus.

Material Changes

(1) Editorial changes have been made throughout.

(2) All dates have been changed to reflect tax year 2016, processing year 2017.

(3) All IPU's issued in PY 2016 have been incorporated in this revision.

(4) IPU 16U0160 issued 01-22-2016 IRM 3.12.12.14.30.2 dealing with EC 955

(5) IPU 16U0160 issued 01-22-2016 IRM 3.12.12.20.29.2 dealing with EC 955.

(6) IPU 16U0160 issued 01-22-2016 IRM 3.12.12.69.1 for processing Form 8941

(7) IPU 16U0160 issued 01-22-2016 IRM 3.12.12.71.44.2 for processing Form 8941.

(8) IPU 16U1102 issued 06-21-2016 IRM 3.12.12.14.13.2 and IRM 3.12.12.20.13.2 to change a word to prior.

(9) IPU 16U1102 issued 06-21-2016 IRM 3.12.12.41.41.2, IRM 3.12.12.53.21.2 and IRM 3.12.12.71.50.2 EC 192, 752 and 770 dealing with Manual Refunds. The system can now generate refunds up to $100 million. We still want them to error out at $10 million to check the figures and clear them if they are under $100 million.

(10) IPU 16U1102 issued 06-21-2016 IRM 3.12.12.71.42.2(6) clarification was added in the correction procedures for EC 758.

(11) Changes were made for EC 991 in IRM 3.12.12.14.47.1

(12) Changes were made in Tables 18 through 30 for Sch H. Field names were changed in some fields.

(13) Changes were made to add Field 0439 to Section 04 and EC 757, 758, 760, 762, and 764. Old Field 0439 is changed to 0440 in all these cases.

(14) Changes were made in Sections 11 and 12 along with EC 955 on the 990 and 990EZ.

(15) A new checkbox was added to Section 21 and EC 766 dealing with Form 8941.

Effect on Other Documents

Manual Transmittal for IRM 3.12.12 dated January 1, 2016 is superseded by this one on January 1, 2017.

Audience

Wage and Investment (W&I) Submission Processing Employees in the Error Resolution and Rejects functions.

Effective Date

(01-01-2017)

Sean O'Reilly,
Or Director, Business Systems Planning SE:T:BSP, Tax Exempt Government Entities.

Service Level Agreements (SLAs)

  1. National Service Level Agreements (SLAs) have been established between Operating Divisions. This section contains specifics regarding SLAs that pertain to activities performed by use of this IRM.

Taxpayer Advocate Service (TAS) SLA

  1. The Taxpayer Advocate Service (TAS) SLA contains basis requirements for handling TAS-referred cases, and includes specific actions to take on TAS referrals and specific time frames for completing those actions.

  2. Per the Taxpayer Bill of Rights, taxpayers have the right to expect a fair and just tax system which provides taxpayers with the opportunity to have their facts and circumstances considered when it might affect their underlying liabilities, ability to pay, or ability to provide information timely. Taxpayers have the right to receive assistance from the Taxpayer Advocate Service (TAS) if they are experiencing financial difficulty or if the IRS has not resolved their tax issues properly and timely through normal channels.

  3. Refer taxpayers to TAS when the contact meets TAS criteria (see IRM 13.1.7, Taxpayer Advocate Service (TAS) Case Criteria), or when Form 911, Request for Taxpayer Advocate Service Assistance (and Application for Taxpayer Assistance Order), is attached and steps cannot be taken to resolve the taxpayer's issue the same day. "Same day" includes cases that can be completely resolved in 24 hours, as well as cases where steps can be taken within 24 hours to begin resolving the issue. (see IRM 13.1.7.4, Same Day Resolution by Operations.) When making a TAS referral, use Form 911, and forward to TAS in accordance with your local procedures.

Operations Assistance Requests (OARs)
  1. TAS and the Operating Functions have reached agreements outlining the procedures and responsibilities for processing Taxpayer Advocate Service (TAS) casework when either the statutory or delegated authority to complete a case transaction rests with that Operating Function. These agreements are known as Service Level Agreements (SLA).

  2. In preparation for a case being referred to an Operating Function, the TAS employee is responsible for:

    1. Preparing Form 12412, Operations Assistance Request.

    2. Securing all necessary supporting documentation.

    3. Identifying cases that require expedite processing. No case will automatically receive expedite processing; requests for expedite processing will be made on a case-by-case basis.

    4. Forwarding Form 12412 and documentation to the Operating Function Unit Liaison.

  3. The Operating Function is responsible for:

    1. Assigning a liaison in each office or Campus where a Taxpayer Advocate is located.

    2. Acknowledging receipt of the case within one workday for cases requiring expedite processing or within three workdays for all other cases.

    3. Providing TAS with the name and telephone number of the group manager or employee assigned the case.

    4. Determining a reasonable timeframe for case resolution.

    5. Upon closing the OAR, the functional employee assigned the OAR will complete Section VI of Form 12412, Operations Assistance Request and return it to the TAS employee assigned the case. The Form 12412 must be returned within three workdays from the date that all actions have been completed and transactions input.

  4. For further information, refer to the SLAs online at http://tas.web.irs.gov/default.aspx under the heading " Policy/Procedures/Guidance."

  5. BMF Identification Theft is increasing. If a tax examiner in Submission Processing (SP) Error resolution System (ERS) finds a case with attachments or correspondence indicating the taxpayer is a victim of ID Theft, provide the whole case to your senior/lead. Your senior/lead will expedite the case to the P&A staff for referral to one of the SP BMF ID Theft liaisons. The taxpayer must clearly state that they are a victim of "ID Theft" .

  6. BMF Identification Theft is increasing. If a tax examiner in Submission Processing (SP) Error resolution System (ERS) finds a case with attachments or correspondence indicating the taxpayer is a victim of ID Theft:

    1. SSPND “360” to route the return to Planning & Analysis (P&A).

    2. Attach Form 4227 (or other appropriate routing slip) with the notation “ID THEFT”.

    3. Provide the entire case to your senior/lead.

    Your senior/lead will expedite the case to the P&A staff for referral to one of the SP BMF ID Theft liaisons. The taxpayer must clearly state that they are a victim of "ID Theft" .

Master File Consistency
  1. The purpose of this initiative is to achieve consistency in the Business Master File (BMF) Error Resolution System (ERS) processing IRMs.

  2. Topics for BMF Consistency have been identified and developed as a coordinated effort between Cincinnati, Ogden, and Paper Processing Branch BMF Code and Edit/ERS.

  3. BMF consistency subsections are identified by a ♦ (diamond) before and after the title.

  4. Text in normal print is the common processes for BMF returns. The text in BOLD print is form specific and applies to this IRM only.

IRM Deviation Procedures
  1. IRM deviations must be submitted in writing following instructions from IRM 1.11.2.2, Internal Management Documents System - Internal Revenue Manual (IRM) Process, IRM Standards, and elevated through appropriate channels for executive approval.

General

  1. The instructions contained in this subsection are used for correcting errors made by taxpayers as well as those made by Submission Processing Center operations. Exempt Organization (EO) processing is centralized at the Ogden IRS Center.

  2. These instructions are for the following forms:

    1. Form 990, Return of Organization Exempt From Income Tax.

    2. Form 990-EZ Short Form Return of Organization Exempt From Income Tax.

    3. Form 990-PF, Return of Private Foundation.

    4. Form 990-N, Information Return of Organization Exempt From Income Tax.

    5. Form 1120-POL- U.S. Income Tax Returns for Certain Political Organizations.

    6. Form 990-T, Exempt Organization Business Income Tax Return.

    7. Form 5227, Split-Interest Trust Information Return

    8. Form 8871, Political Organization Notice of Section 527 Status

    9. Form 8872, Political Organization Report of Contributions and Expenditures

    10. Form 5768, Election/Revocation of Election by an Eligible Section 501(c)(3) Organization to Make Expenditures to influence Legislation.

    11. Form 1041-A, U.S. Information Return–Trust Accumulation of Charitable Amounts

    12. Form 4720, Return of Certain Excise Taxes on Charities and Other Persons Under Chapters 41 and 42 of the Internal Revenue Code

    13. Form 5578, Annual Certification of Racial Nondiscrimination for a Private School Exempt from Federal Income Tax

  3. These instructions pertain to the Error Resolution System (ERS) and paper registers. They are your main source of information for correcting the record on the screen/register and the related return. You will also find procedures in:

    1. IRM 3.12.38.0, Error Resolution (ERS), General Instructions, and,

    2. IRM 3.11.12.0, Exempt Organization Returns, Document Perfection instructions.

  4. Cade 2

    1. The Customer Account Data Engine (CADE) 2 Program Office in Headquarters is charged with the primary goal to implement a single, modernized programming solution which provides daily processing of taxpayer accounts.

      Note:

      The CADE Master File, as it existed from 2004–2011, will transition from Production and be retired at the end of cycle 201152.

    2. The CADE 2 solution is comprised of several components, to modernize the IRS to a daily processing environment with several Transition States.

    3. With CADE 2 there will be changes to campus cycles which will begin with cycle 201201. The new BMF, EO, and EPMF campus cycles are:
      (a) Campus Cycle: Thursday - Wednesday
      (b) Master File Processing: Friday - Thursday
      (c) Notice Review Saturday: Monday (8+ days)
      (d) Unpostables: New available Tuesday; Closing Tuesday

    4. BMF, EO and EPMF transaction posting timeframes are outlined as follows:
      (a) Transactions will be viewable using CFOL command codes on Saturday following the weekly Master File processing run on Thursday.
      (b) Transactions will be viewable as posted transactions using IDRS command codes on Monday following the weekly Master File processing run on Thursday.

      Note:

      With the acceleration of the IDRS weekly analysis being performed the weekend directly after the Master File processing on Thursday, transactions will be posted instead of in pending status on Monday.

    5. Transaction posting dates will reflect a format of YYYYCCDD. YYYY will indicate the year. CC will indicate the posting cycle. For IMF transactions, the following values for DD are defined:
      01 = Friday
      02 = Monday
      03 = Tuesday
      04 = Wednesday
      05 = Thursday

      Note:

      BMF, EO and EPMF transaction posting dates will continue to reflect YYYYCC. YYYY will indicate the year. CC will indicate the posting cycle.

Extent of Review Required

  1. You are not expected to review or redo the work of the Document Perfection examiner. However, if an error or omission made by the examiner is noticed while working the return in error, enter the correct information on the return, screen display or paper register as applicable.

  2. A complete review of the return is not required. If this section instructs you to do something without telling you how, refer to IRM 3.11.12.

    Note:

    If corresponding review the complete return to make sure you request everything missing.

Imaging Process

  1. All Forms 990/990-EZ, 990-PF, 990-T, 5227, 4720, and 8872 will be scanned through the imaging process.

  2. The exception to (1) above are returns filed to only to claim the, Credit for Small Business Health care on Form 8941 and claims for Backup withholding are not to be imaged and should not be sent to Imaging.

  3. Forms 990/990-EZ, 990-PF, 990-T, 5227, 4720, and 8872 must be routed to Imaging when all errors are corrected and any of the following apply:

    1. There is no indication of previous filming, e.g., the absence of "Filmed" or "Scanned " stamp in the left margin of the first page.

    2. New information is received from the taxpayer through Rejects/Unpostable correspondence. This only includes missing or incomplete schedules, missing signatures and (correspondence for Schedule B check box). A Document 7214 (refilm tag) needs to be attached in front of the pages that need to be refilmed.

    3. Also route returns to Imaging we received from filers due to correspondence that will be processed. An example would be a 990 when a 990-EZ was filed in error. These would be considered original returns, not re-films. Forms sent to Imaging as original returns would not have a Document 7214 (refilm tag) attached. Use a regular routing slip.

      Note:

      When sending a 990 received from the filer to be processed, cancel the DLN of the 990-EZ filed in error and staple it to the back of the Form 990 and Renumber the Form 990.

      Note:

      Exception: Substitute for Returns (SFR) should not be imaged through the Imaging System. SFR returns received without the words filmed or scanned should not be sent to the imaging function.

    Note:

    Do not mark information that is not new (e.g. Do not mark the signature page on the correspondence if original return was signed.). If sending a return received from the filer such as a 990 when a 990-EZ was filed in error, it is not a re-film. This is considered an original return. Send it to Imaging on a regular routing slip, not a re-film document.

  4. Securely attach Document 7214 in front of the pages which require filming.

Due Date of Returns

  1. Form 4720 has the same due date as Forms 990/990-EZ or Form 5227 filed by the same organization.

  2. The due date for Forms 990/990-EZ, 990-PF, 990-N, Form 990-T (IRC 501(c) Trusts and Corporations) and Form 5578 is the 15th day of the fifth month after the organization's accounting period ends.

  3. The delinquent date for Forms 990/ 990-EZ, 990-PF, 990-N, Form 990-T (IRC 501(c) Trusts and corporations) and Form 5578 are shown below:

    ACCOUNTING
    PERIOD
    MONTH
    ENDING
    DUE DATE
    DELINQUENT
    DATE
    01 6/15 6/23
    02 7/15 7/23
    03 8/15 8/23
    04 9/15 9/23
    05 10/15 10/23
    06 11/15 11/23
    07 12/15 12/23
    08 1/15 1/23
    09 2/15 2/23
    10 3/15 3/23
    11 4/15 4/23
    12 5/15 5/23
  4. The due date for Forms 1120-POL is the 15th day of the third month after the organization's accounting period ends.

  5. The delinquent dates for Forms 1120-POL are shown below:

    ACCOUNTING
    PERIOD
    MONTH
    ENDING
    DUE DATE
    DELINQUENT
    DATE
    01 4/15 4/23
    02 5/15 5/23
    03 6/15 6/23
    04 7/15 7/23
    05 8/15 8/23
    06 9/15 9/23
    07 10/15 10/23
    08 11/15 11/23
    09 12/15 12/23
    10 1/15 1/23
    11 2/15 2/23
    12 3/15 3/23
  6. The due dates for Form 990-T (IRC 401(a), 408(a), and 408(e) Trust) is the 15th day of the fourth month after the organization's accounting period ends.

  7. The delinquent dates for Form 990-T (IRC 401(a), 408(a), and 408(e) Trust) are shown below:

    Note:

    Form 5227 and Form 1041-A must always have a calendar year (due 4/15). Use the chart below only to determine the due date for a "final" Form 5227.

    ACCOUNTING
    PERIOD
    MONTH
    ENDING
    DUE DATE
    DELINQUENT
    DATE
    01 5/15 5/23
    02 6/15 6/23
    03 7/15 7/23
    04 8/15 8/23
    05 9/15 9/23
    06 10/15 10/23
    07 11/15 11/23
    08 12/15 12/23
    09 1/15 1/23
    10 2/15 2/23
    11 3/15 3/23
    12 4/15 4/23
  8. Form 8871 is filed once initially and must be filed electronically. Paper Forms 8871 will be returned to the filer by EO Entity using Letter 3710C. Amended and Final Forms 8871 can be filed but must also be electronically filed.

  9. Form 8872 can be filed electronically or on paper. It must be filed at least once a year. No filing requirements are established on Master File. The due date for Form 8872 varies depending on whether it's an election year or non-election year. The 527 organization can choose to file it's reports quarterly or monthly during election (Even Numbered) years or on a semiannual or monthly basis during non-election (Odd Numbered) years.

    Note:

    If either the total amount of contributions on Line 9 or the total amount of expenditures on Line 10 are over $50,000.00, the Form 8872 must be filed electronically. The DLN will be cancelled and the form will be sent to EO Entity to have the image removed from the website and the Form 8872 returned to the filer instructing them to file electronically. If Line 9 is over $50,000.00 and the organization indicates they could not file electronically because they do not have a user id or password, continue processing the paper return.

  10. The Type of Report, Line 8 Checkbox of Form 8872 is used to determine the due date for the return. This Line will be transcribed as a 1 through 8 based on which box was checked by the filer. A 1 = a, 2 = b, 3 = c, 4 = d, 5 = e, 6 = f, 7 = g, and 8 = h.

  11. The delinquent dates for Form 8872 (527 Political Organizations) are shown below:

    Note:

    This table is for Election (Even Numbered) Years.

    Line 8 = DUE DATE
    DELINQUENT
    DATE
    1 4/15/yyyy
    (1st quarterly report) where yyyy = the tax period year
    4/23/yyyy
    2 7/15/yyyy
    (2nd quarterly report) where yyyy = the tax period year
    7/23/yyyy
    3 10/15/yyyy
    (3rd quarterly report) where yyyy = the tax period year
    10/23/yyyy
    4 1/31/yyyy
    (4th quarterly report) where yyyy = the year following the tax period year.
    1/23/yyyy
    6 mm/20/yyyy
    (monthly filed report for each month except October and December) where yyyy = the tax period year
    mm/28/yyyy
    7 10/8/yyyy
    Where the yyyy = the tax period year. The report is actually due 12 to 15 days prior to the election (Pre-election report)
    10/16/yyyy
    8 12/08/yyyy
    Where the yyyy = the tax period year. The report is actually due 30 days after the Tuesday following the first Monday in November (Post election report)
    12/08/yyyy

    Note:

    This Table is for Non-Election (Odd Numbered) years.

    Line 8 = DUE DATE
    DELINQUENT
    DATE
    4 1/31/yyyy
    (year end report) where yyyy = the year following the tax period year
    2/08/yyyy
    5 7/15/yyyy
    (mid-year report) where yyyy = the tax period year
    7/23/yyyy
    6 mm/20/yyyy
    (monthly filed report for each month except December which is due on 1/31/yyyy of the following year) where yyyy = the tax period year
    mm/28/yyyy
  12. The return is considered delinquent if the Received Date ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ .

Audit Codes

  1. Valid Audit Codes and their definitions are:

    Audit Code Condition Description
    1 Frivolous return (Form 990/990-EZ Only) Entered if the return is frivolous and the filer has not responded to a request for Schedule A or Field 01NPF is blank.
    2 No reply to Schedule A (Form 990/990-EZ only) Entered when taxpayer doesn't respond to request for Schedule A.
    Possible Form 3520 required (Form 1120-POL only) The "Yes" box is checked for Question 2 on Form 1120-POL.
    3 No reply to tax period (Form 990, 990-EZ, 990-PF, 990-T, 5227, 8872 and 4720) Entered when taxpayer doesn't respond to FYM mismatch
    4 Form 4720 with no taxable amount Entered when there is no tax information.
    5 Form 990-PF (reserved)
    Form 4720 not to be returned to the field

    Entered when the return has been secured by Examination. An edited " P" will be shown after the printed Form 4720.
    blank All but Form 1041–A and 5578
  2. Audit Code Priority: If more than one Audit Code condition is present, the Audit Code with the lowest number takes precedence.

Field Secured/
Field Prepared Returns

  1. EO Compliance functions secure returns from the filer and also prepare returns if the filer does not provide a return.

  2. Identify a field secured or field prepared return by any of the following:

    1. Return or attachment is noted with wording similar to "SFR" , "Substitute for Return" or " §6020(b)" .

    2. Return or attachment is noted with wording similar to "Delinquent Secured Return" or "Secured by TE/GE" .

Field Secured Returns
  1. A field secured return is a return obtained from the filer by EO field personnel.

  2. Identify as a secured return if the return or attachment is noted with wording similar to "Delinquent Secured Return" or "Secured by TE/GE" .

  3. Route the secured return to the Area Office via Form 4227 notated "Unprocessable Secured Return" if the organization's name and EIN are missing.

  4. Correspond for missing schedule(s) or missing signature as required.

  5. Enter CCC "R" , "D" and/or "V" if applicable if the Area Office indicated that penalties and/or interest should not be assessed.

    Note:

    Correspond for missing information on a Field secured Return (by agent from taxpayer).

Substitute For Return
  1. A substitute for return is prepared by EO compliance functions if the filer does not provide a return. The return can be identified as a substitute for return by wording similar to "SFR" , " Substitute for Return" or "§6020(b)" anywhere on the document. The agent will edit "TC 599 CC96" at the bottom margin of the return. At the top of the return, the agent will write "Substitute for Return Secured by TE/GE" .

  2. Do not correspond for missing information on returns marked Substitute for Return, SFR, or 6020(b).

  3. Enter CCC "R" and/or "V" if applicable if the Area Office indicated that penalties and/or interest should not be assessed.

    Note:

    If the return is a CIS (Correspondence Imaging System) return with or without a Form 13596 attached follow the normal correspondence procedures. DO NOT cancel the DLN and send the return to Accounts Management.

Correspondence and Taxpayer Contact Requirements

  1. Section 3705(a) of the Restructuring and Reform Act of 1998 requires all IRS employees who communicate with taxpayers by telephone, correspondence, or face to face, to give their name and unique identification number and telephone number when communicating with taxpayers.Check the IRI Codes to ensure the correct codes have been entered. If not, delete the incorrect codes and enter the correct ones. For valid IRI Codes see IRM 3.12.12.9.14.2.

    Note:

    Prior to initiating any correspondence a check on IDRS must be made to see if a return, TC 150 has already posted to the account. If a TC 150 is on the account for the tax period involved, enter a G Code and process as a G coded return. Do not issue any correspondence. Accounts Management will receive the G coded return and make the determination whether correspondence is needed.

    Note:

    Prior to corresponding for any missing information a check of the Status Code on INOLE should be made. If the account is in Status 97 it means the organizations Tax Exempt status has been revoked. This applies to Forms 990, 990-EZ, and 990-PF. If the account is in status 97 DO NOT CORRESPOND for any missing information. Enter a 24 in Field 01COR and CCC R, V and 3 and continue processing the return. We don't want to correspond with the filer since they have been revoked and correspondence would give the filer the impression we accepted their return. If a Form 990-EZ is filed and a 990 is required process the Form 990-EZ, enter 14 in Field 01COR and CCC R, V and 3. DO NOT correspond for a Form 990.

  2. All correspondence must include the following:

    1. Employee's title (Mr., Mrs., Ms., or Miss)

    2. Employee's last name

    3. Employee's badge identification number or IDRS number

    4. A telephone number where the taxpayers questions can be answered

  3. If the employee initiating the correspondence is not in the best position to respond to questions the taxpayer may have about the correspondence, the correspondence needs only IRS telephone number and standard signature.

Incomplete Returns Program
  1. The Service has implemented an "Incomplete Returns Program" for Forms 990, 990-EZ, and 990-PF filers for certain missing information.

  2. Check the IRI Codes to ensure the correct codes have been entered. If not, delete the incorrect codes and enter the correct ones. For valid IRI Codes see IRM 3.12.12.9.14.2.

    Note:

    Prior to initiating any correspondence a check on IDRS must be made to see if a return, TC 150 has already posted to the account. If a TC 150 is on the account for the tax period involved, enter a G Code and process as a G coded return. Do Not issue any correspondence. Accounts Management will receive the G coded return and make the determination whether correspondence is needed.

    Note:

    Prior to corresponding for any missing information a check of the Status Code on INOLE should be made. If the account is in Status 97 it means the organizations Tax Exempt status has been revoked. This applies to Forms 990, 990-EZ, and 990-PF. If the account is in status 97 DO NOT CORRESPOND for any missing information. Enter a 24 in Field 01COR and CCC R, V and 3 and continue processing the return. We don't want to correspond with the filer since they have been revoked and correspondence would give the filer the impression we accepted their return. If a Form 990-EZ is filed and a 990 is required process the Form 990-EZ, enter 14 in Field 01COR and CCC R, V and 3. DO NOT correspond for a Form 990.

  3. This program does not apply to:

    1. Group returns (see IRM 3.11.12.2.9, 10, and 11).

    2. Tax Period 198311 and prior.

    3. Filing Requirement 06 or 13 - Churches not required to file.

    4. Limited Forms 990-PF. Do not correspond for any issue if Form 990-PF is marked by the taxpayer as " Revenue Procedure 78-8" or "Limited" on the return or attachments. See IRM 3.12.12.29.1 for additional information on Limited Forms 990-PF.

    5. Reprocessed Returns: If the return was previously a No-Reply, do not correspond again for the missing information. Treat as a No-Reply and continue processing.

  4. Now that we are only corresponding once it is very important that you are careful and correspond for all missing information in the first letter.

  5. The information which indicates that the return is incomplete is shown in your Job Aid.

    Note:

    When Corresponding refer to these exhibits.

  6. We will no longer correspond twice on Incomplete Return Items. Correspond once and if there is no-reply, follow the same procedures you would have followed for a no-reply to the second correspondence in the past.

Unsigned Return
  1. If the return is unsigned, correspond for the missing signature, missing signatures will now be considered an IRI Item on any return the IRI process is used. DO NOT correspond for missing signatures on returns printed from the CIS system, returns with "This is a live return from SMIP" across the top or MEF returns that have "e-File GRAPHIC print DO NOT PROCESS" across the top of the return. A signature can consist of either an original signature (including a printed signature, rubber stamped, mechanical device or signed by a software program.

    Note:

    If a TC 150 has posted and you have an amended return, process the correspondence for the signature only. See IRM 3.12.38.5.17.1 for additional instructions for determining an amended return.

  2. Filing of original tax returns via fax will only be allowed as part of a return perfection process (e.g., securing missing schedule or missing signature) initiated by the IRS where contact with the taxpayer has been made and documented. These faxed signatures will be accepted as well as those received from any internal source.

    Note:

    If a return has no information below the Entity Section, A true Zero Filer return, 2007 and Prior Forms 990/990-EZ, correspond for a FYM mismatch, missing signature, incorrect revision of form, or the return is a final/termination and all required information is not present only. If money amounts are present, correspond for all issues. If the return is a 2008 and subsequent revision of Form 990/990-EZ the "Zero Filer, ORG Code 9" process will no longer be followed. If a return is filed it must be complete and we will correspond like any other return.

  3. Returns may have originally been filed electronically (E-File). These returns may be identified by the presence of MOD E-File printouts in lieu of an actual return or wording such as "e-file GRAPHIC print - DO NOT PROCESS" printed at the top of the return. Do not correspond for missing signatures on these documents if they are being reprocessed and they were originally accepted through the E-File system.

    Note:

    Paper returns sent in by the filer that state they were rejected through the E-File system do require a signature.

  4. When corresponding for a missing signature only use the 3875-C letter. If you are corresponding for other missing information also, use the 2694-C, 2695-C, 2696-C, 2697-C, 2698-C or 2699-C. as appropriate.

    Note:

    When corresponding for missing signatures on Forms 990, 990-EZ or 990-PF, SSPND 211. C&E is discontinuing the use of Form 13157 when corresponding for missing signatures. They will write 211 or 215 at the bottom margin of page one of the return on Forms 990, 990EZ, and 990-PF. For Forms 990-T, 1120-POL, 5227, 5768, and 8872 C&E will continue to use Action Code 225 or 226. CCC U will continue to be used on Form 4720, Part II-A..

    Note:

    Prior to corresponding for any missing information a check of the Status Code on INOLE should be made. If the account is in Status 97 it means the organizations Tax Exempt status has been revoked. This applies to Forms 990, 990-EZ, and 990-PF. If the account is in status 97 DO NOT CORRESPOND for any missing information. Enter a 14 in Field 01COR and CCC R, V and 3 and continue processing the return. We don't want to correspond with the filer since they have been revoked and correspondence would give the filer the impression we accepted their return.

Unprocessable Conditions (Non-IRI)
  1. There are items requiring correspondence with the filer throughout the text. These items (non-IRIs) are not part of the "Incomplete Returns Program" . Only the items in Exhibit 3.12.12-13 through Exhibit 3.12.12-16 are " Incomplete Return Items (IRIs)" . For non-IRI correspondence issues, see Exhibit 3.12.12-7.

    1. When initiating correspondence, always include both the IRIs and non-IRIs in the same request.

      Note:

      Prior to corresponding for any missing information a check of the Status Code on INOLE should be made. If the account is in Status 97 it means the organizations Tax Exempt status has been revoked. This applies to Forms 990, 990-EZ, and 990-PF. If the account is in status 97 DO NOT CORRESPOND for any missing information. Enter a 14 in Field 01COR and CCC R, V and 3 and continue processing the return. We don't want to correspond with the filer since they have been revoked and correspondence would give the filer the impression we accepted their return.

  2. Initiate correspondence with the taxpayer if Document Perfection has not done so. Use Letter 2694-C (2008 and Subsequent Form 990) or 2698-C (2007 and Prior Form 990), Letter 2695-C (2008 and Subsequent Form 990-EZ) or 2699-C, (2007 and Prior Form 990-EZ), Letter 2697-C (Form 990-PF) or Letter 2696-C (Form 1120-POL, 990-T, 1041-A, 5227, 4720, 5578, and 8872).

  3. When a reply is received for non-IRIs , enter the CRD and COR "11" (COR is not valid for Form 1120-POL).

  4. If no reply is received for non-IRIs , enter CCC "3" and COR "14" (COR is not valid for Form 1120-POL).

  5. If incomplete reply is received for non-IRIs, enter CCC "3" and COR " 12" or "13" (COR is not valid for Form 1120-POL).

Correspondence Replies/No Replies
  1. Process correspondence replies as follows:

    1. Enter the Correspondence Received Date (CRD) as the date the response is received in Field 01CRD or Field 01-H as applicable.

    2. If all information is provided, enter Correspondence Indicator (COR)"11" in Field 01COR or Field 01-G for non IRI issues and 21 for IRI issues as applicable.

    3. Check the IRI Codes and ensure the correct codes have been entered. If not, delete the incorrect codes and enter the correct codes. For valid IRI Codes see IRM 3.12.12.9.14.2.

  2. If the taxpayer does not furnish the information requested and does not provide reasonable cause, See Exhibits 3.12.12-8 through 3.12.12-16. See IRM 3.12.12.2.6.7 and Figure 3.12.12-1 for reasonable cause procedures.

    Note:

    If the filer responds and says he filed a 990-N instead of sending us the missing information, check BMFOLT or TXMOD to be sure a 990-N has posted. If a 990-N posted pull the return from suspense, cancel the DLN and destroy the return using local procedures. If the call site receives information that the filer has sent in a 990-N they will research to see that the 990-N posted and send a F-4442 to Rejects to have the return pulled, the DLN cancelled and return destroyed. They will tell the filer to ignore the request for missing information.

  3. If the filer responded to the request with a type of form other than originally filed, make sure you refer to the latest form received in any subsequent correspondence (e.g. Form 990-EZ was filed originally and the filer responded to the first request by filing a Form 990).

  4. If Schedule A is not submitted enter Audit Code "2" in Field 01ADC.

  5. Prior to corresponding for any missing information a check of the Status Code on INOLE should be made. If the account is in Status 97 it means the organizations Tax Exempt status has been revoked. We don't want to correspond with the filer since they have been revoked and correspondence would give the filer the impression we accepted their return.

Undeliverables
  1. If the letter is returned as Undeliverable:

    1. Compare the address on the letter with the return.

    2. If different, re-send the letter to the address on the return.

    3. If the same, research INOLES for the address.

  2. If the address on INOLES is different or there is a "location address" , re-mail the original letter to the new address.

    Note:

    Do not prepare a new correspondence action sheet. Also See IRM 3.12.38.10(5).

  3. If the address on INOLES is the same as the return, send the letter to the following address, if available, in priority order:

    1. Address where books are located, Part VI, Line 20, (2008 and Subsequent Form 990). Part VI, Line 91 (2007 and Prior Form 990). Part V, Line 42a, (2008 and Subsequent Form 990-EZ). Part V, Line 42, (2007 and Prior Form 990-EZ), Part VII-A, Line 12, (Form 990-PF), Line 5c, Additional Information, (Form 1120-POL), Item J, Page 1, (Form 990-T), not applicable for Form 1041-A, 5227, 4720 or 5578.

    2. Address of the paid preparer, bottom of page 1, (2008 and Subsequent Form 990), Bottom of page 4. (2008 and Subsequent Form 990-EZ), bottom of page 6 (2007 and Prior Form 990) and 4720); bottom of page 2 (2007 and Prior Form 990-EZ/990-T/1041-A), bottom of page 12 (Form 990-PF), bottom of page 1 (Form 1120-POL), bottom of page 4 (Form 5227), not applicable for Form 5578.

    3. Address of an officer, Part VII, page 7 (2008 and Subsequent Form 990), Part V (2007 and prior Form 990), Part IV, page 2 (2008 and Subsequent Form 990-EZ), Part IV (2007 and Prior Form 990-EZ), Part VIII, Item 1 (Form 990-PF), not applicable for Form 1120-POL, 990-T, 1041-A, 5227, 4720 or 5578).

    4. Business address of Organization, Line 7 (Form 8872).

  4. If no better address is available, treat as "no reply" .

  5. If the letter is undeliverable a second time using the new address, treat as "no reply " .

Frivolous Returns and Claims
  1. A frivolous argument is used for the purpose of expressing dissatisfaction with the substance, form or administration of the tax laws by attempting to illegally avoid or reduce tax liabilities. Recognized frivolous arguments made by businesses include, but are not limited to, the examples in IRM 25.25.10, Frivolous Return Program (FRP).

  2. Review the return to determine whether it appears to be a frivolous return.

    If... Then...
    The return meets any of the conditions identified as a frivolous return.

    Note:

    Exception: If the return shows Action Code 331 and has a Form 4227 attached with the remarks, Refer to Exam FRP for audit after processing, continue to next procedure.

    Remove return from the batch and place the return in the locally designated basket for Examination, Frivolous Return Processing (FRP) for review.
    Examination has selected the return as frivolous, indicated by an Action Code 331 and a Form 4227 with the remarks "Refer to Exam FRP for audit after processing" , but send the return for processing, Continue processing the return using procedures in IRM (form specific). However, do not circle or void the Action Code indicating a frivolous return.

    Note:

    ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ "≡ ≡ ≡ ≡ " ≡ ≡ "≡ ≡ ≡ ≡ ≡ ≡ " ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡

Reasonable Cause
  1. For the Incomplete Returns Program, the reasonable cause must state why the information cannot be furnished and/or why it wasn't furnished when the return was initially filed.. Refer to Figure 3.12.12-1:

    1. When the filer furnishes reasonable cause for late filing, but does not provide reasonable cause for an incomplete return, the reasonable cause for late filing will not apply to the Incomplete Returns Program. The return will be treated as if the reasonable cause was not furnished.

    2. If reasonable cause is furnished for late filing but not for the missing items, send a second letter.

    3. Ensure CCC "R" and " V" are not present if reasonable cause should not be allowed.

    Figure 3.12.12-1

    • The return was mailed in time but was returned to sender.
    • The return was filed in time but sent or deposited to the wrong IRS office.
    • Delay or failure to file was due to erroneous information given to the taxpayer by an IRS employee.
    • Delay was caused by death or serious illness of the taxpayer, or a death or serious illness in his/her immediate family (see Note below).
    • Delay was caused by unavoidable absence of the taxpayer (see Note below).

    Note:

    In the case of a corporation, estate, trust, etc., the death, illness or absence must have been of an individual (or member of the individual's immediate family) having sole authority to execute the return.


    • Delinquency was caused by destruction, by fire or other casualty of the taxpayers place of business or business records.
    • Taxpayer requested the proper forms in a timely fashion, but the forms were not furnished in sufficient time to permit the timely filing of the return.
    • Taxpayer provides proof that he/she personally visited an IRS office on or before the due date of the return for the purpose of securing the information or advice and was unable to meet with an IRS representative.

    If the organization is a PRIVATE FOUNDATION: The organization has 90 days to file and pay after it received a determination letter from the Service. Revenue Procedure (Rev. Proc) 79-8 allows a private foundation (Form 990-PF) reasonable cause for failure to file and failure to pay for 90 days after it received a determination letter from the Service stating that the organization is a private foundation or that it cannot reasonably be expected to be a public charity. (This relief does not apply to returns or schedules that would have been due whether or not it was a private foundation (for example Form 990-T). A copy of the redetermination letter should be attached to the return.

    If the organization is NOT A PRIVATE FOUNDATIONS with UBIT (unrelated taxable business income) or NOT A TAXABLE ORGANIZATION (not a Form 990-PF or Form 990-T filer), is a membership organization (PTA, Boy Scout Troop, Garden club, Homeowners Assn., etc.), and has no full-time employee responsible for administering the organization's finances, reasonable cause may be granted if the organization:
    1. Clearly shows it exercised normal care and prudence, but was unable to file the return timely due to little continuity or understanding of duties due to frequent office changes,
    or
    2. Has no prior history of late filing and claims ignorance of the law (new organizations or those not previously required to file).

    Source: Internal Revenue Manual 20.1., Rev. Proc. 79-8, Policy Statement P-2-7, P-2-9, and P-2-11., and Law Enforcement Manual (LEM) 20.1.

Electronically Filed Returns

  1. Forms 990, 990-EZ, 990–PF, and 1120-POL, may be filed electronically through the Modernized e-File (MeF).

  2. Form 8871 and Form 990-N must be filed electronically. Form 8872 may also be filed electronically through a web based system. The data is passed to GMF through a tier 2 system for both forms.

    Note:

    If either the total amount of contributions on Line 9 or the total amount of expenditures on Line 10 are over $50,000.00, the Form 8872 must be filed electronically. The form will be sent to EO Entity to have the image removed from the website and the Form 8872 returned to the filer instructing them to file electronically. If Line 9 is over $50,000.00 and the organization indicates they could not file electronically because they did not have a user id or password, continue processing the paper return.

  3. Forms filed electronically are corrected in ERS using the same procedures as a manually transcribed document.

  4. Electronically filed Forms 990, 990-EZ, 990-N and 1120-POL can be identified by File Location Code 93 or 92. They also have unique program codes, 13310 (Form 990, 2007 and prior), 13320 (Form 990-EZ, 2007 and prior), 13380 (Form 990, 2008 and subsequent), 13390 (Form 990-EZ, 2008 and subsequent.), 13350 (Form 990-N), and 13370 (Form 1120-POL).

    Note:

    Certain organizations are now required to file Forms 990–990EZ and 990PF electronically. If a return is received through MEF and research indicates a paper return has already been received, DO Not Delete the MEF Return as a duplicate or Amended Return. The MEF filing may be due to correspondence we sent the filer instructing them to file electronically.

Electronically Filed Rejected Returns
  1. If an organization attempts to file a return electronically and is unable to do so, the electronic return originator (ERO) will receive notification from the Service that the return was not accepted for processing. The ERO is required to inform the filer of the reject within 24 hours, provide the filer with an explanation of why the return was not accepted through the electronic system, and inform them they must file a paper return.

  2. A paper return received after the return due date will be considered timely filed if the filer indicates on the return or an attachment that an unsuccessful attempt was made to timely file electronically and the paper return is received within 10 days of the notice of rejection.

  3. The received date should be the return due date if (2) above applies.

Field Length Errors
(Overfilled Fields)

  1. An invalid condition could exist if a field does not have enough positions.

Correction Procedures
  1. SSPND 351 or enter Action Code " 3" as applicable to reject the return.

  2. Rejects should contact the EO ERS/Reject Program Analyst at (801) 620-5044. The issue will be responded to within 48 hours of contact.

Manual Refunds

  1. Document Perfection is responsible for identifying refunds and for initiating requests for manual refund that are not identified by existing error processing. Expeditious processing for refund returns is critical if the 45-day period is about to expire.

  2. Action Code 341 (ERS returns) or CCC "U" (paper register returns) should be edited by Document Perfection to show that a manual refund is needed. If these conditions are not identified in Document Perfection, Error Resolutions must follow the criteria below:

    If Then
    ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ 1. Enter Action Code 341 (ERS) or Action Code "3" (paper register) as applicable.
    2. Rejects will follow procedures in IRM 3.12.38 for issuing a manual refund.
    ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ 1. Enter Action Code 341 (ERS) or Action Code "3" (paper register) as applicable.
    2. Rejects will follow procedures in IRM 3.12.38 for issuing a manual refund. More information is available in IRM's 3.17.79, Accounting Refund Transactions, 3.17.80, Working and Monitoring Erroneous Refunds 21.4.4, Manual Refunds, and 21.4.5, Erroneous Refunds.

Form 1128, Change in Accounting Period

  1. If Form 1128, Change in Accounting Period, is found attached to a return during processing, the return will be routed to Rejects for research.

  2. Rejects will research the entity module to determine if the FYM change requested by the Form 1128 has been made:

    If Then
    the FYM change has been made (TC 053), continue processing the return
    the FYM change has not been made (TC 055), Suspend or Reject to Entity as applicable.

General Correction Procedures
Form 990/990EZ (2008 and subsequent revision), 990/990-EZ (2007 and prior revision), 990-PF, 1120-POL, 990-T, 5227 and 8871/8872

  1. Records will be placed into Error Resolution or Rejects inventories for correction.

  2. Once you access a record and it displays on the screen you must resolve the error by either:

    1. Fully correcting the record, or

    2. Placing the record in suspense until additional information is received, or

    3. Rejecting the record from pipeline processing.

  3. Corrections will include correcting errors in editing, transcription or taxpayer errors.

  4. In the header portion of each record, the error screen displays will show:

    1. Document Locator Number (DLN),

    2. Employer Identification number (EIN), and

    3. Name Control or Check Digit

  5. Before making corrections to the Error Screen displays, verify that the DLN of the display matches the DLN of the document.

  6. If it is determined that a mixed data situation exists, stop processing and give the block of work to your manager. Management will determine if the mixed data can be corrected via the terminal screen display, or will take action to have the block deleted and re-input.

  7. When making corrections to the Screen Display, be sure money amounts within a section have been transcribed in dollars only, or in dollar and cents according to the requirements shown in the instructions for each section.

  8. Before assigning a TPNC, check for any schedules or attachments the filer may have used in arriving at the amount in the field in error.

Action Code 001

  1. Action Code 001 will be computer generated when the BOB Resolution Function has added a missing document by only inputting the TIN and the Name Control for the missing document:

    • All data must be entered.

    • GTSEC ALL sections and

    • Enter ALL necessary data.

Clear Fields "C" and "000"

  1. The letter "C" is used as a Clear Field for the Error Codes (consistency errors) when the invalid condition does not require a change or correction to the record as displayed. The display will include a clear field, labeled "CL" to indicate the possible need of a Clear Field. Command Code CRECT is used to enter the "C" .

  2. Error Codes that need a Clear Field are cleared by either correcting the condition or entering a "C " to indicate no correction is needed.

  3. Clear Field "C" is also used for clearing the Action Code after corrections for the Action Code have been completed.

  4. "000" is also used as a Clear Field when deleting Action Codes. It will only be used for erroneous Action Codes when you have determined there is no reason to suspend the record ("000" cannot be used in Reject correction).

  5. Programming erases all "C" Clear Fields for Error Codes when a record is suspended with the Command Code SSPND.

  6. Programming erases all "C" Clear Fields for Error Codes and Action Codes for the new day's Error Inventory and Workable Suspense Inventory.

    Note:

    Unfinished records from the previous day will not contain the " C" Clear Fields that were assigned to a record that was not completely worked.

  7. Error Codes (including the ones which may require a "C" Clear Field) are numbered consecutively in order for correcting.

Action Code Error Priority I

  1. All records assigned an incorrect Action Code will be displayed as a Priority 1 error. These errors and the correction procedures are explained in this section:

    1. If the Action Code is valid (except 001), it will be placed in the Reject inventory.

    2. If the Action Code is invalid or is 001, it will be placed in the error inventory. See IRM 3.12.12.3.1 and IRM 3.12.12.3.2.

Section Errors Priority II

  1. There are two types of Priority II Errors: ISRP and TERMINUS Errors. These errors and correction procedures are explained in this section.

ISRP (Integrated Submission & Remittance Processing) Errors

  1. An ISRP error is an error detected by the Integrated Submission & Remittance Processing.

  2. The display for the ISRP error will include the code identifying the type of ISRP error:

    1. "1" —Split screen transmission, Key Verifier attempted to change Check Digit, Key Verifier changed 4 or more digits of a TIN, or the Original Entry operator entered required section as missing.

    2. "3" —Invalid section ending point.

    3. "4" —Invalid field length.

    4. "Questionable Section " —The ISRP operator input the same section more than once or entered out of sequence by ISRP. The computer program will drop all duplicate sections and display on the error register the first one encountered.

  3. When displayed, ISRP errors will display all input fields of the section in error, except for the Remittance in Section 01. Transcribed data will be present. Computer generated data will not be present.

ISRP Error Correction Procedures
  1. Check all fields of the section and verify that fields are entered as coded.

    1. If no correction is needed, or once the section is correct, drop to the bottom of the screen and transmit.

    2. If the section needs to be deleted, enter Command Code DLSEC with the section number.

Terminus Error

  1. A Terminus Error occurs when a section with variable length input fields contains an erroneous sized field.

  2. When displayed, a Terminus Error will show all input fields of the terminus section.

    1. Transcribed data will be present.

    2. Computer generated fields or Remittance Field for Section 01 will not be present.

Terminus Error Correction Procedures
  1. All fields present for the section must be examined and the necessary correction(s) made to all the fields.

  2. If the section needs to be deleted, use Command Code DLSEC to delete the section.

  3. If no corrections are needed, drop to the bottom of the screen and transmit.

Field Errors Priority III

  1. Definition—Any field that does not meet the requirements for that field will be shown as a Priority III Error. Some reasons for this type of error are:

    1. Non-alphabetical character in an alpha field

    2. Blank space in a numeric field

    3. Blank in the first position of an alpha field

    4. Non-numeric character in a numeric field

    5. A required field is blank

Priority III Error Display Order

  1. All fields with a Priority III Error will be displayed in the order encountered in the record.

  2. This chapter lists the fields, errors and correction procedures for Priority III Errors for Forms 990, 990-EZ, 990-N, 990-PF, 1120-POL, 990-T, 5227 and 8871/8872. Unless otherwise stated the fields are valid for Forms 990, 990-EZ, 990-N, 990-PF, 1120-POL, 990-T, 5227 and 8871/8872.

Taxpayer Notice
Codes (TPNC)

  1. Use this code when a math error is present involving the tax liability or tax due/overpayment. Enter it on the terminal screen following the literal "NC" . You must also enter the TPNC on the upper left corner of the return.

  2. Enter the TPNC after determining that no corrections to the record are needed. The presence of a TPNC indicates to the computer that no other corrections to the screen display will be made.

  3. Whenever you assign a TPNC, a working trail showing the changes made must also be entered on the return at the point of error and on the Total Tax line.

  4. Each math error has certain TPNCs that are valid to clear the math error. The TPNC assigned to the error and entered in the "NC" Field must be valid for that Error Code. If an invalid code is assigned, the error will be displayed again.

  5. Each math error display requires a correction to a field or the entry of a TPNC. The transmission of a TPNC must not be accompanied by any other correction. A TPNC assigned to a math error is displayed on subsequent displays for the record. The field is used for display purposes only and is not correctable.

  6. A return can have a total of three TPNCs. If more than three codes need to be assigned, use TPNC 90 and list the error for Notice Review to type and send to the taxpayer.

  7. TPNC 90 is actually a fill-in and is used when no other TPNC fully explains the correction(s) made or when more than three notice codes are necessary. Write an explanation exactly as it should appear on the notice and attach it to the face of the return. Notice Review will type the math error explanation on the notice before mailing to the taxpayer. TPNC 90 can be used in conjunction with other notice codes.

  8. Once a code is transmitted to the record, it can be changed in the following manner:

    1. Records cleared from the terminal—If errors remain after transmitting the TPNC, you can create an error with a higher priority. This deletes all "C" Clear Fields and notice codes already assigned a lower priority error from the record. TPNCs are deleted from the header display. Beginning with the high Priority IV error created, all subsequent errors are displayed for resolution even though they were displayed previously.

    2. A correction you make erases an error code you previously cleared with a TPNC or "C" . In this case, the " C" or TPNC and all subsequent error codes are displayed. The TPNC(s) for this error and subsequent error codes are deleted from the header display.

    3. Records that were worked may be reworked using Command Code GTRECW. See IRM 3.12.38, BMF ERS General Information, for further details.

    4. All TPNCs are erased when a record is suspended with Command Code SSPND.

    5. Unfinished records from the previous day will contain none of the TPNCs that were assigned to the records.

  9. See Exhibit 3.12.12-20 through Exhibit 3.12.12-23 for TPNCs that are valid for Forms 990-PF, 1120-POL, and 990-T.

Form 990 2008 and Subsequent Sections and Fields

  1. Form 990 contains Sections 01 through 13.

  2. Tables with field designations, maximum field length, and field titles are listed before each section.

Section 01
Field Descriptions

  1. Section 01 contains entity data, processing codes, dates and miscellaneous information.

  2. Listed below are the fields contained in Section 01 showing the Field Designator, title, location on the return, and the maximum length:



    FIELD


    FIELD TITLE


    LOCATION
    MAX.
    LENGTH
    RMIT< Remittance Blue/Green Money 11
    01NC Name Control/Check Digit Entity Section 4
    <<<< Name Control Underprint 4
    01EIN Employer Identification Number EIN Block 9
    01TXP Tax Period Entity Section 6
    << Tax Period Underprint 2
    01CCC Computer Condition Code Right Portion of Lines 2–7b 10
    01RCD Received Date Date Stamp 8
    01ORG Organization Code Right of Item K 1
    01SS Sub Section Right of Item I 2
    01NPF Non-PF Reason Code Right margin, Part I 2
    01ADC Audit Code Edit Sheet Line 2 1
    01GRP Group Return Code Box HB 1
    01COR Correspondence Indicator Edit Sheet Line 4 2
    01CRD Correspondence Received Date Edit Sheet Line 5 8
    01IRI IRI Code Page 2 Top 10
    01CAF CAF Indicator Edit Sheet Line 3 1
    01DDP Daily Delinquency Penalty Edit Sheet Line 7 6
    <<<< Daily Delinquency Underprint 6
    01SCA Schedule Indicator Code Top of Page 3 20 Alpha Numeric
    01SCB Schedule Indicator Code Top of Page 3 10 Alpha Numeric
    01PRE Preparation Code Right margin, of Preparer PTIN Line 1
    01PSN Preparer PTIN Part II Signature Block 9
    01PEN Preparer EIN Part II Signature Block 9
    01PTN Preparer Phone Number Part II Signature Block 10

Field RMIT<
Remittance Amount

  1. Field RMIT< is the Remittance Amount. It is dollars and cents and is the blue/green edited money amount. This field cannot be changed by Error Resolution.

Field 01NC
Name Control/Check Digit

  1. Field 01NC is the Name Control and Check Digit field.

  2. Name Control: This field is located in the Entity Section of the return.

  3. Check Digit: This field is also a four position field. There must be blanks in the first two positions and a letter of the alphabet (other than E, G or M) in the third and fourth positions.

Field 01NC
Invalid Conditions
  1. This field is invalid if:

    1. For Name Control, the first position is not alpha or numeric, the 2nd, 3rd or 4th position is not an alpha, numeric, hyphen, ampersand or blank, and there are any intervening blanks between characters.

    2. For Check Digit, the first two positions are not blank and a letter of the alphabet (other than E, G or M) in the third and fourth positions is not present.

Field 01NC
Correction Procedures
  1. Check Field 01NC with the return. Correct any coding or transcription errors. Check Digits have priority over the Name Control. The method for determining the correct Name Control is shown in Document 7071, Name Control Job Aid, and (2) through (6) below.

    1. If the Check Digit or Name Control is not available, initiate research using Command Code ENMOD, NAMEE, NAMEB, or INOLES to secure the Name Control. If unable to secure the Name Control, SSPND 320.

    2. If IDRS is not available, SSPND 351.

  2. The name control should be the first four characters of the name as follows:

    1. If the organization is a corporation (e.g., name includes "Corporation" , "Inc." , "Foundation" , "Fund" ), edit the first four characters of the corporation name. Omit the word "the" when followed by more than one word.

    2. If the organization is an individual, trust, or estate, edit the first four characters of the last name of the individual, trustee, beneficiary, or decedent.

    3. If the organization is a political organization or political committee (Section 527), edit the first name of the individual.

  3. If an organization's name contains both "Fund" or "Foundation" and "Trust" , apply either corporate or trust name control rules as follows:

    If Then
    The organization name contains the name of a corporation, apply corporate name control rules (see (2)a. above).
    The organization name contains an individual's name, apply trust name control rules (see (2)b. above).
  4. Specific corporate name control examples to be used if "Corporation" , "Inc." , "Foundation" , or "Fund" are not present are:

    1. Local, Chapter, or Post—Edit the first four characters of the name of the national organization if the words "Local" , "Chapter" , or "Post" are contained in the name.

    2. Habitat for Humanity — Edit Habi

    3. Little League — Edit Litt

    4. American Legion — Edit Amer

    5. AMVETS — Edit Amer

    6. Boy Scouts of America (BSA) — Edit Boys

    7. BPOE — Edit Bene

    8. FOE — Edit Frat

    9. VFW — Edit Vete

    10. PTA—Edit PTA plus the first letter of the name of the state

    11. PTO or PTSA— Edit the first four charac ters of the school

  5. Specific trust or estate name control examples are:

    1. Estate—Edit the first four characters of the last name of the decedent

    2. Corporate Trust—Edit the first four characters of the Corporation's name.

    3. Individual trust—Edit the first four characters of the last name of the individual

    4. All other trusts—Edit the first four characters of the last name of the trustee or beneficiary

  6. Specific political organization name control examples are:

    1. Friends of Jane Doe — Edit Jane

    2. Committee to Elect John Smith — Edit John

    3. Citizens for John Doe — Edit John

Field 01EIN
Employer Identification Number (EIN)

  1. Field 01EIN is the Employer Identification Number.

  2. The EIN is a number assigned by IRS for identification of a business tax account. This field is located in the EIN Block

Field 01EIN
Invalid Conditions
  1. This field is invalid if:

    1. It is not numeric,

    2. It is less than nine characters,

    3. The first two digits are: 00, 07-09, 17-19, 28, 29, 49, 78, 79 or 89,

    4. It is all zeros or all nines.

Field 01EIN
Correction Procedures
  1. Check Field 01EIN with the return. Correct any coding or transcription errors.

  2. If the EIN was entered correctly, search for another valid EIN on the return and attachments and enter the correct number.

  3. If a correct number cannot be determined:

    1. Research using Command Code NAMEB or NAMEE for the correct number.

    2. SSPND 351 if IDRS is not available.

    3. SSPND 320 if more than one number is found or if you are unable to determine a valid EIN. Indicate multiple EINs on Form 4227.

  4. If EIN is changed from the one the taxpayer used, issue Letter 3875-C as a non-suspense letter to the address on the return. Continue processing the return.

    Note:

    Do not send Letter 3875-C If:
    * Less than three digits of the EIN are transposed, different or missing.
    * When CC INOLE indicates the account has been merged to or merged from, or
    * An SSN is used on a return and research has determined there is no entity on Master File when the number is in EIN format.

Field 01TXP
Tax Period

  1. Field 01TXP, Tax Period, is YYYYMM format.

Field 01TXP
Invalid Conditions
  1. This field is invalid if:

    1. It is not numeric,

    2. Month is not 01-12,

    3. It is equal to or later than the Processing Date.

    4. Tax period is before 197012 for Form 990.

Field 01TXP
Correction Procedures
  1. Check the return and attachments for the correct Tax Period. Correct any coding or transcription errors.

  2. If the Tax Period is equal to or later than the Processing Date, check to see if it is a "Final" return.

    1. For non-final returns, if the tax period is more than three months but less than one year from the current date, correspond for confirmation of the tax period.

    2. If tax period is less than four months, SSPND 480. Attach Form 4227 indicating "early filed" .

    3. If the return is a"Final," use Command Code GTSEC for Section 01 and enter "F" in Field 01CCC, if necessary. Change the Tax Period to the month preceding the received date.

  3. Edit CCC F (Final/Termination) if ALL of the following apply:

    1. The return or an attachment is marked Final/Termination.

    2. There are other indications the organization is out of business, closed, or merged.

    3. Part X, Line 16(B) is 0 (zero) or blank.

    4. Part IV, Line 31 is marked yes.

    5. Not a group return - item H(a)-(b) is no or blank and item H(c) is blank.

    6. If the taxpayer is attempting to file a Final/Termination, Form 990 and (a)-(e) are not met, correspond.

    7. Schedule N, Part I is attached. If not attached correspond.

  4. If the Tax Period is prior to 198901 for Form 990-EZ, SSPND 610. Rejects will convert and process as Form 990.

  5. If the Tax Period is prior to 197012 for Form 990, SSPND 620. Attach Form 4227 stating "non-ADP" .

Field 01CCC
Computer Condition Codes

  1. Field 01CCC is the Computer Condition Codes. Field 01CCC is transcribed from the right portion of lines 2-7b, Form 990 See Exhibit 3.12.12-17 for a description of the codes and their uses.

Field 01CCC
Invalid Conditions
  1. This field is invalid if:

    1. The entry is other than blank, "D " , "F" , "G" , " L" ,"R" , "T" , " V" , "W" , "Y" , " 3" or "7" ,

    2. CCCs "F" and " Y" are both present,

    3. CCC "7" is present with both CCCs "D" and "R" .

Field 01CCC
Correction Procedures
  1. Compare the entry on the screen to the entry on the return. Correct any coding or transcription errors.

  2. If the codes were entered correctly, refer to the return and See Exhibit 3.12.12-17 to determine which codes are necessary.

  3. If CCCs "F" and "Y" are both present, determine if it is a final return. Identify Form 990 returns as "Final" only if ALL of the following apply:

    1. The return or an attachment is marked " Final" , or there is other indication the organization is out of business, closed or merged.

    2. Total Assets End of Year (Part X, Line 16(B)), Form 990 are zero or blank.

    3. Part IV, Line 31 is checked yes.

    4. It is not a group return.

    5. Schedule N, Part I is attached. If not attached and it is a final return, correspond.

      Note:

      This applies for all returns marked Final.

  4. If the return is not a final return, delete the "F" code.

  5. If the return is a final return or is not for a short period, delete the "Y" code.

  6. If CCCs "7" , " D" , and "R" are all present, determine the correct CCCs:

    1. If CCC "7" is correct delete the "R" and " D" .

    2. If CCC "7" is not correct, delete CCC "7" .

  7. The only CCC codes valid with CCC "G" are CCC "3" and "W" .

Field 01RCD
Received Date

  1. Field 01RCD is the Received Date. It is YYYYMMDD format. This field is required and is transcribed from the date stamp on page one of the return.

Field 01RCD
Invalid Conditions
  1. This field is invalid if it is:

    1. Not present,

    2. Not in YYYYMMDD format,

    3. Later than the current processing date,

    4. Not within the valid year, month, day range,

    5. Prior to the ADP date of 197012 for Form 990.

Field 01RCD
Correction Procedures
  1. Compare Field 01RCD with the received date stamp on the return. Correct any coding or transcription errors.

  2. If the Received Date stamp is "invalid" (I.E. 20110115 in lieu of 20120115), correct accordingly.

  3. If the filer indicates on the return or an attachment that an unsuccessful attempt was made to timely file electronically, enter a timely received date.

  4. Determine the received date in the following priority when it is required and there is no valid date stamp or handwritten received date:

    Note:

    If an envelope is not attached use the postmark date stamped on the face of the return.

    1. The envelope postmark or delivery shipment date.

      Note:

      If a date is stamped, the priority list would not be needed; however, if there is more than one received date stamped on the document, the proper date would depend whether the document was properly addressed. If the document is properly addressed but the Service misrouted the document, the earliest date stamp would be used. If the document is not properly addressed, the date it was stamped received at the proper address would be used.

    2. Service Center Automated Mail Processing System (SCAMPS) digital date

    3. The Revenue Agent/Officer's signature date

    4. The signature date

    5. The Julian in the DLN, minus 10 days

    Note:

    Use signature date only if the signature date is within the current processing year.

    Caution:

    The≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ from the Return Due Date (RDD), regardless of Saturday, Sunday or holiday extension dates.

Field 01ORG
Organization Code

  1. Field 01ORG, Organization Code , is transcribed in the blank space of Item K. This field is used to identify the type of organization filing the return.

Field 01ORG
Invalid Conditions
  1. This field is invalid if other than " 1" , "3" , or "4" .

Field 01ORG
Correction Procedures
  1. Correct any coding or transcription errors.

  2. If necessary, refer to the return to determine the correct code. Valid codes are:

    IF RETURN SHOWS: CODE
    IRS Subsection 01-25, 29, 50, 60, 70, 71, or Item I, 501(c) box is checked, 1

    Item I is blank

    Research for correct code
    Item I, 4947(a)(1), box is checked 3
    IRS Subsection 91 3
    the 527 box is checked in Item I of the entity section (SS82), 4
  3. If no boxes are checked on Item I and the return does not have a pre-addressed label, research INOLES for the correct subsection. Code accordingly.

Field 01SS
Sub Section

  1. Field 01SS, Sub Section, is located in blank space of Item I.

Field 01SS
Invalid Conditions
  1. This field is invalid if other than 00, 02 through 20, 22 through 27, 28, 29, 50, 60, 70, 71, 81, 82, or 91.

Field 01SS
Correction Procedures
  1. Refer to Item I to determine the correct code. Correct any coding or transcription errors.

  2. If no errors are found, research INOLES for the correct code. Valid codes are 00, 02 through 20, 22 through 28, 29, 50, 60, 70, 71, 81, 82, or 91.

  3. If there is no SS on INOLES and the return is for a " National Railroad Retirement Investment Trust" , enter " 28" in Field 01SS. If the Tax Period for the "National Railroad Retirement Investment Trust" is prior to 199312, also enter "R" and "V" in Field 01CCC.

  4. If unable to determine correct Sub Section, enter "00 " in Field 01SS.

Field 01NPF
Non-PF Reason Code

  1. Field 01NPF, Non-PF Reason Code , is transcribed from the right margin of Schedule A, Part I.

Field 01NPF
Invalid Conditions
  1. This field is invalid if other than 01 through 15 or blank.

Field 01NPF Correction Procedures
  1. Correct any coding or transcription errors.

  2. Refer to Schedule A, Part I, to determine the correct code. Valid codes are:

    Subsection Foundation Code NPF Code Box that should be checked
    03 10 01 1
    03 11 02 2
    03 12
    Hospital, Clinic
    03 3
    03 12
    Research, Lab
    05 4
    03 13 06 5
    03 14 04 6
    03 15 07 7
    03 15
    Community Trust
    08 8
    03 16 09 9
    03 18 11 10
    03 21
    Type I checked
    12 11a
    03 22
    Type II checked
    13 11b
    03 23
    Type III functionally checked
    14 11c
    03 24
    Type III non-functionally checked
    15 11d
    50 03 3
    70 09 9
    60, 71, 91 10 11

    Note:

    If Box 11 is checked one of the Type Boxes described above must also be checked.

    Note:

    If PTA and box 2 is checked and correspondence for Schedule E is needed, research for the correct NPF Code. If the Foundation Code is not 11, change the NPF Code and do not correspond for Schedule E.

    * Use NPF 03 if the organization's name included "Hospital " , "Clinic" , etc.
    ** Use NPF 05 if the organization's name includes " Research" or "Laboratory " , etc.

Field 01ADC
Audit Code

  1. Field 01ADC, Audit Code, is located on Line 2 of the edit sheet.

Field 01ADC
Invalid Conditions
  1. This field is invalid if other than " 1" , "2" , "3" , or blank.

Field 01ADC
Correction Procedures
  1. Refer to Line 2 of the Edit Sheet to determine the correct code. Correct any coding or transcription errors.

  2. Correct codes are:

    1. Blank—This field must be blank if Field 01ORG is "9" or the following conditions (b) through (d) do not apply.

    2. 1—Frivolous return and taxpayer has not provided a Schedule A or Field 01NPF is blank.

    3. 2—Schedule A or Non-PF Reason Code is missing.

    4. 3—No reply to FYM mismatch correspondence.

  3. Audit Code Priority: If more than one Audit Code condition is present, the Audit Code with the lowest number takes precedence.

Field 01GRP
Group Return Code

  1. Field 01GRP, Group Return Code, is transcribed from the right margin of Page 1, Form 990, next to Box HB.

  2. ISRP will transcribe a "1" or "2" which will be converted to a "7" or "8" in GMF processing.

Field 01GRP
Invalid Conditions
  1. This field is invalid if other than "1" , "2" or blank.

Field 01GRP
Correction Procedures
  1. Correct any coding or transcription errors.

  2. Refer to the return to determine the correct code. Identify a group return in one of the following ways:

    1. Group Return is noted on the return or attachment.

    2. Item H(a) of the entity section is "yes" and the Group Exemption (GEN) is written in Item H(c).

    3. There is a list of subordinates attached.

    4. There is a statement on the return or attachment that all affiliates are included on the group return.

    Note:

    If Item H(a) is checked "No" and Item H(b) is checked "Yes" , DO NOT consider the return a group return.

  3. Valid Group Return Codes are:

    1. Blank—if the return is not for a group.

    2. 1—group return with a list indicating all the affiliates are included, or there is no response to correspondence.

    3. 2—group return with a list indicating only some of the affiliates are included. (Rejects will input FRM49 per (5) below.)

  4. Use Group Return Code "2" if there is an attachment or statement indicating that not all affiliates are included on the return, or if GEN #0229 (Line H(c)) is present. Correspondence is required if a list of affiliates isn't present.

  5. Once a list of affiliates to be included in the filing is received, Rejects will:

    1. Verify the parent's EIN and verify that the parent EIN is on the BMF by using IDRS Command Code INOLES before inputting TC 590.

    2. Input Command Code FRM49, TC 590, Closing Code 14, for each of the affiliates covered by the return.

      Note:

      Transaction Code 590 with Closing Code 14 requires the parent EIN as part of the transaction.

Field 01COR
Correspondence Indicator

  1. Field 01COR, Correspondence Indicator , is located on Line 4 of the Edit Sheet.

Field 01COR
Invalid Conditions
  1. This field is invalid if other than " 11" , "12" , "13" , " 14" , " 21" , "22" , "23" , " 24" or blank.

Field 01COR
Correction Procedures
  1. Refer to Line 4 of the Edit Sheet to determine the correct code. Correct any coding or transcription errors.

  2. Refer to the return and any attached correspondence to determine the correct code. Correct Correspondence Indicators are:

    1. 11—Reply with all information— Use when the taxpayer's response to our request is complete; all of the information we requested is provided. (Enter the CRD if after the RDD.)

    2. 12—Reply with some information— Use when the taxpayer provides some of the information we requested, (Enter CCC "3" .)

    3. 13—Reply with no information— Use when the taxpayer responds to our first inquiry, but does not provide the information we requested, (Enter CCC "3" .)

    4. 14—No Reply—Use when the taxpayer does not respond to our request, (Enter CCC "3" .)

    5. 21—Reply with all information—Use when the taxpayer's response to our request for missing IRI items is complete; all of the information we requested is provided. (Enter the CRD if after the RDD).

    6. 22—Reply with some information—Use when the taxpayers provides some of information we requested on missing IRI items. (Enter CCC 3 and the appropriate entry in Field 01IRI).

    7. 23—Reply with no information—Use when the taxpayers responds on missing IRI items but does not provide the information we requested. (Enter CCC 3 and the appropriate entry in Field 01IRI).

    8. 24—No Reply—Use when the taxpayer does not respond to our request for missing IRI items. (Enter CCC 3 and the appropriate entry in Field 01IRI)

Field 01CRD
Correspondence Received Date

  1. Field 01CRD, Correspondence Received Date, is in Year, Month, Day (YYYYMMDD) format.

  2. Field 01CRD is located on Line 5 of the Edit Sheet. It is used when correspondence was initiated. The entry reflects the date a complete reply was received.

Field 01CRD
Invalid Conditions
  1. This field is invalid if:

    1. It is not numeric or blank,

    2. It is not in YYYYMMDD format,

    3. It is not in valid century, year, month, day range.

Field 01CRD
Correction Procedures
  1. Refer to Line 5 of the Edit Sheet to determine the correct date. Correct any coding or transcription errors.

  2. Refer to the return and any attached correspondence to determine the correct date.

Field 01IRI
IRI Code

  1. Field 01IRI is located,on page 2 in the upper right margin.

  2. There can be a maximum of 5 – 2 digit codes present for a total of 10 characters.

Field 01IRI
Invalid Conditions
  1. This field is invalid if other than 2 digit numeric or blank.

Field 01IRI
Correction Procedures
  1. The codes and their meanings are as follows:

    Correspondence Items IRI Code
    Missing Signature 90
    Part VII 87
    Part VIII 88
    Part IX 89
    Part X 80
    Entire or wrong revision of Schedule A 20
    Sch. A Part I 21
    Sch. A Part II 22
    Sch. A Part III 23
    Sch. B 50
    Sch. C 51
    Sch. D Part I 52
    Sch. E 53
    Sch. L 54
    Sch. R 55
    Sch, J 56
    Sch. H 57
    Sch. O 58
    Audited Financial Statement 59
  2. Correct any coding or transcription errors using the above chart.

  3. Check the IRI Codes to ensure the correct codes have been entered. If not, delete the incorrect code(s) and enter the correct codes.

Field 01CAF
CAF Indicator

  1. Field 01CAF, CAF Indicator, is no longer edited by Document Perfection. If this field displays, delete the entry.

Field 01DDP
Daily Delinquency Penalty

  1. Field 01DDP, Daily Delinquency Penalty, is located on Line 7 of the Edit Sheet.

Field 01DDP
Penalty Amounts
  1. The law provides for a daily penalty for failure to file a return (determined with regard to any extension of time for filing) or for filing an incomplete return unless failure is due to reasonable cause.

    Exception:

    Churches not required to file (FRC 06).

    1. For tax years ending on or after July 30, 1996, the penalty is $20 a day. The maximum penalty may be as much as $10,000 or five percent of gross receipts for the year, whichever is less.

    2. For tax years ending before July 30, 1996, the penalty is $10 a day. The maximum penalty may be as much as $5,000 or five percent of gross receipts for the year, whichever is less.

    3. If the organization has gross receipts exceeding $1,000,000.00 for any year the law provides for a penalty of $100 a day. The maximum penalty may be as much as $50,000.

Field 01DDP
Invalid Conditions
  1. This field is invalid if:

    1. It is not numeric,

    2. The last digit is other than zero and the Tax Period is prior to 198712.

Field 01DDP
Correction Procedures
  1. Refer to Line 7 of the Edit Sheet to determine the correct entry. Correct any coding or transcription errors.

  2. If transcribed correctly and penalty was computed by a Revenue Officer or Examination, SSPND 640 and prepare Form 4227. Annotate on Form 4227 "cancel to Exam" . DO NOT change the DDP amount unless instructed by the preparer to do so.

Fields 01SCA and SCB
Schedule Indicator Codes

  1. Field 01SCA and SCB Schedule Indicator Codes are transcribed from the top of Page 3.

  2. This field is edited based on the answers to the questions in Part IV. This field is edited with an alpha/numeric character for each schedule that is attached and not blank. If more than 20 characters are present in Field 01SCA, Field 01SCB will need to be used. This is due to constraints on the ERS Screen display.

Fields 01SC and SCB
Invalid Conditions
  1. These fields are invalid if not alpha, numeric or blank.

    Note:

    We no longer accept any substitute schedules. The only exception are forms and schedules that are prepared that are exactly like official IRS forms and schedules.

Fields 01SCA and SCB
Correction Procedures
  1. Refer to the top of Page 3 to determine the correct code(s). Correct any coding or transcription errors. Correct codes are:

    1. Blank—If there are no required schedules.

    2. A, B, C, D, D1, E, F, G, H, I, J, K, L, M, N, O, or R should be edited if a complete schedule is attached.

      Note:

      Only enter the SIC Code if the Schedule is present. If corresponding for a missing schedule only enter the SIC Code if a complete schedule is sent in with a reply.

    3. If the question on Line 6, Part IV is yes, Schedule D 1 is required.

Field 01PRE
Preparation Indicator

  1. Field 01PRE, Preparation Indicator , is transcribed from the bottom right margin of the Preparers PTIN box.

Field 01PRE
Invalid Conditions
  1. This field is invalid if other than " 1" or blank.

Field 01PRE
Correction Procedures
  1. Refer to the signature area to determine the correct code. Correct any coding or transcription errors. Correct codes are:

    1. Blank—If the signature or name of the preparer is not present.

    2. 1—If the signature, name of the preparer, or firm name is present.

      Note:

      A paid preparer may sign the original return by rubber stamp, mechanical device, or computer software.

Field 01PSN
Preparer PTIN

  1. Field 01PSN , Tax Preparer PTIN, is transcribed from the preparer PTIN box in the signature portion of the return.

  2. The entries are any combination of numerics except all "zeros" or all " nines" . The first character may be a " P" .

Field 01PSN
Invalid Conditions/
Correction Procedures
  1. Field 01PSN is invalid if the first position is other than numeric or "P" .

  2. Field 01PSN is invalid if the field is all zeroes or all nines or the first position is "P" and the remaining positions are all zeroes or all nines.

  3. Field 01PSN is invalid if other than the first position is not numerics.

  4. Delete the field. Do not attempt to correct the field.

Field 01PEN
Preparer EIN

  1. Field 01PEN, Tax Preparer EIN, is transcribed from the preparer EIN box in the signature portion of the return.

  2. The entries are any combination of numerics except all "zeros" or all " nines" . The first character may be a " P" .

Field 01PEN
Invalid Conditions/
Correction Procedures
  1. Field 01PEN is invalid if the field is all zeros or all nines.

  2. Field 01PEN is invalid if it is not all numerics.

  3. Delete the field. Do not attempt to correct the field.

Field 01PTN
Preparer Telephone Number

  1. Field 01PTN Preparer Telephone Number is transcribed from the Preparer Block form Page 1, Form 990, Preparers Phone Number.

Field 01PTN
Invalid Conditions
  1. This field is invalid if not 10 digits, all numeric.

Field 01PTN
Correction Procedures
  1. If less than 10 digits or unable to determine the correct phone number, Delete Field 01PTN.

Section 02
Data Address Fields

  1. Section 02 contains address changes and the In-Care-of-Name Line.

    If... Then...
    The INOLES address is the same as the address on the return, Delete Section 02 if nothing is present in Field 02CON. If Field 02CON is present, Delete the Address only.
    The INOLES address is different from the address on the return, Research ENMOD for a pending address change, TC 014.
    A pending address change is found on ENMOD, Delete Section 02 if nothing is present in Field 02CON. If Field 02CON is present, Delete the Address only.
    No pending address is found on ENMOD. SSPND 320 to Entity Control for address change.

Section 02
Field Descriptions

  1. Listed below are the fields contained in Section 02 showing the field designator, title, location on the return, and maximum length:



    FIELD


    FIELD TITLE


    LOCATION
    MAX.
    LENGTH
    02CON Care of Name Entity Section 35
    02FAD Foreign Address Entity Section 35
    02ADD Street Address Entity Section 35
    02CTY City Entity Section 22
    02ST State Entity Section 2
    02ZIP ZIP Code Entity Section 12

Field 02CON
In Care of Name Line

  1. Field 02CON, In Care of Name Line,is located in the Entity Section of the return.

  2. Field 02CON has 35 positions and the valid characters are alpha, numeric, ampersand, dash, slash or percent.

    Note:

    The first character of the "in-care-of" name must be alpha or numeric.

Invalid Conditions
  1. This field is invalid if any of the following conditions exist:

    1. The first position is a % sign and the second position is not blank.

    2. The first character of the "in-care-of" name is not alpha or numeric.

    3. There are two consecutive blanks between significant characters.

Correction Procedure
  1. Check for transcription errors and correct as needed.

    If... Then...
    A % (percent) is in the first position,
    1. Verify there is a blank in the second position.

    2. If not blank enter a blank followed by the "in-care-of" name beginning with an alpha or numeric in Field 02CON.

    A blank is in the first position,
    1. Delete blank.

    2. Enter the "in-care-of" name beginning with an alpha or numeric in Field 02CON.

    The first character of the "in-care-of" name is not alpha or numeric,
    1. Verify "in-care-of" name on return.

    2. Enter the "in-care-of" name beginning with an alpha or numeric in Field 02CON

    Two consecutive blanks present between significant characters,
    1. Delete any unnecessary blanks in Field 02CON.

Field 02FAD
Foreign Address

  1. Field 02FAD is located in the Entity Address Section of the return. This Section will contain data when a foreign address is present on the return. Field 02FAD should not be present on "G" Coded returns.

  2. Code & Edit will use //$ to identify the beginning and ending of a foreign country code. For example /EI/$ is edited for Ireland and /GM/$ is edited for Germany.

Field 02FAD
Invalid Conditions
  1. This Field is invalid if any of the following conditions exist:

    1. The field contains other than alpha, numeric or special characters,

    2. The first position is blank,

    3. Any character follows two consecutive blanks,

    4. There are more than 35 characters present for this field on the return.

    Note:

    ISRP is instructed to input a pound sign (#) as the 35th character if there are more than 35 characters present for this field on the return.

Field 02FAD
Correction Procedures
  1. 1. Correct all coding and transcription errors.

    If... Then...
    Field 02FAD is present
    1. GETSEC 02

    2. Ensure Field 02CTY contains a foreign country code and Field 02ST contains a "." (period/space)

    A foreign address is not present on the return
    1. SSPND 610

    2. Renumber return to domestic.

  2. If Form 8822 (Change of Address) is attached to the return, compare the name and address information on the Form 8822 to the return.

    If... Then...
    The information is the same Take no action and continue processing.
    The information is different
    1. Detach Form 8822.

    2. Route to Entity Control on Form 4227 or follow local procedures.

    3. Annotate on Form 4227, "CHANGE OF ADDRESS PER FORM 8822. "

    Note:

    The lead Tax Examiner is required to batch all Forms 8822 daily and send them to Entity Control for expedite processing.

Field 02ADD
Street Address

  1. Field 02ADD, Street Address, is located in the Entity Section of the return. This section will contain data on non-preaddressed returns when the address change box has been checked or on preaddressed labels when a change has been indicated.

Field 02ADD
Invalid Conditions
  1. This field is invalid if any of the following conditions exist:

    1. The street address is present and the first position is blank,

    2. Any character not alphabetic, numeric, blank, hyphen, or slash is present,

    3. There are two consecutive blanks followed by valid characters,

    4. The first position is not alphabetic or numeric.

Field 02ADD
Correction Procedures
  1. Check the screen entry with the entry on the return and attachments. Correct any coding or transcription errors.

  2. If the field cannot be perfected, delete Section 02 if Field 02CON is not present. If Field 02CON is present, delete the address only.

Field 02CTY
City

  1. Field 02CTY, City, is located in the entity section of the return.

Major City Code
  1. Certain cities within each state are designated "Major Cities" and are assigned a special code of two alpha characters.

    1. The Major City Code represents both the city and state.

    2. ISRP will enter the Major City Code as appropriate.

    3. It is transcribed with no intervening blanks and no other characters in the City or State fields.

Field 02CTY
Invalid Conditions
  1. This field is invalid if:

    1. Any character not alphabetic or blank is present,

    2. City is present and the first position is blank,

    3. City is present and the second and third positions are blank,

    4. Any characters follow the first two adjoining blanks,

    5. An invalid Major City Code is present,

    6. Fewer than three characters are present unless a valid Major City Code is present.

  2. Refer to Document 7475, State Abbreviations, Major City Codes and Address Abbreviations, for valid Major City Codes.

Field 02CTY
Correction Procedures
  1. Compare the screen entry with the entry on the return and attachments. Correct any coding or transcription errors.

  2. If unable to correct, delete Section 02 if Field 02CON is not present. If Field 02CON is present, delete the address only.

Field 02ST
State

  1. Field 02ST, State, is located in the entity section of the return.

Field 02ST
Invalid Conditions
  1. This field is invalid if it is not contained in the State Code Table in Document 7475.

Field 02ST
Correction Procedures
  1. Check the field on the screen with the entry on the return and attachments. Correct any coding or transcription errors.

  2. If unable to perfect, delete Section 02 if Field 02CON is not present. If Field 02CON is present, delete the address only.

Field 02ZIP
ZIP Code

  1. Field 02ZIP is the ZIP Code. It is located in the entity section of the return.

Field 02ZIP
Invalid Conditions
  1. This field is invalid if:

    1. Blank.

    2. The fourth and fifth position are 00.

Field 02ZIP
Correction Procedures
  1. Check the field on the screen with the entry on the return. Correct any coding or transcription errors.

  2. If a valid ZIP Code is not on the return, check any attachments and envelope. Research INOLES, refer to Document 7475.

  3. If a valid ZIP Code cannot be located, use the first three digits of the ZIP Code for the city or state and 01 for the fourth and fifth digits.

Section 03
Field Descriptions

  1. All of the fields in this section and are located in Part III.

  2. Listed below are the fields contained in Section 03 showing the field designator, title, location on the return, and maximum length:




    FIELD



    FIELD TITLE
    LINE
    NO.
    990
    MAX.
    LENGTH
    0332 Did Organization Undertake Significant Part III, Line 2 1
    0333 Did Organization Cease Conducting Part III, Line 3 1
    0334A Exempt Purpose Code 1 Part III, Line 4a 5
    0334B Exempt Purpose Code 2 Part III, Line 4b 5
    0334C Exempt Purpose Code 3 Part III, Line 4c 5

Section 03
Invalid Conditions/
Correction Procedures

  1. These fields are invalid if they are not all numeric or blank.

  2. Refer to the return to verify the entry. Correct any coding or transcription errors.

    Note:

    The Exempt Purpose Codes are not currently being used and should be blank.

Section 04
Field Descriptions

  1. Listed below are the fields contained in Section 04 showing the field designator, title, location on the return, and maximum length:




    FIELD



    FIELD TITLE


    LINE
    NO.

    990
    MAX.
    LENGTH
    041 Is Organization 501(c) (3) or 4947(a)(1)? Part IV, Line 1 1
    042 Schedule B Code Part IV, Line 2 1
    043 Engage in Political Activity? Part IV, Line 3 1
    044 Engage in Lobbying Activity? Part IV, Line 4 1
    045 Subject to Section 6033(e) Notice? Part IV, Line 5 1
    046 Maintain Donor Advised Funds? Part IV, Line 6 1
    047 Receive or Hold Conservation Easements? Part IV, Line 7 1
    048 Maintain Collections? Part IV, Line 8 1
    049 Provide Credit Counciling? Part IV, Line 9 1
    0410 Hold Assets or Endowments? Part IV, Line 10 1
    0411A Land, Buildings and Equipment? Part IV, Line 11a 1
    0411B Investments Other Securities? Part IV, Line 11b 1
    0411C Investments Program Related? Part IV, Line 11c 1
    0411D Other Assets Part IV, Line 11d 1
    0411E Other Liabilities? Part IV, Line 11e 1
    0411F Sepatrate or Consolidated Financial Statements? Part IV, Line 11F 1
    0412A Separate Independent Audited Financial? Part IV, Line 12a 1
    0412B Consolidated Independent Audited Financial? Part IV, Line 12b 1
    0413 Is the Organization a School? Part IV, Line 13 1
    0414A Maintain an Office? Part IV, Line 14a 1
    0414B Have Aggregate Revenues or Expenses? Part IV, Line 14b 1
    0415 Report more than $5,000 on Part IX, Line 3 for ORGS Outside US? Part IV, Line 15 1
    0416 Report more than $5,000 on Part IX, Line 3 for Individuals Outside US? Part IV, Line 16 1
    0417 Report more than $15,000 on Part IX, Lin4e 11e? Part IV, Line 17 1
    0418 Report more than $15,000 on Part VIII, Line 1c and 8a? Part IV, Line 18 1
    0419 Report more than $15,000 on Part VIII, Line 9a? Part IV, Line 19 1
    0420A Operate Hospitals? Part IV, Line 20a 1
    0420B Audited Financial Statement? Part IV, Line 20b 1
    0421 Report more than $5,000 on Part IX, Line 1? Part IV, Line 21 1
    0422 Report more than $5,000 on Part IX, Line 2? Part IV, Line 22 1
    0423 Answer yes to Questions 3, 4 or 5? Part IV, Line 23 1
    0424A Tax Exempt Bonds Outstanding? Part IV, Line 24a 1
    0424B Invest any Net Proceeds? Part IV, Line 24b 1
    0424C Maintain an Escrow Account? Part IV, Line 24c 1
    0424D Act on Behalf of Issuer? Part IV, Line 24d 1
    0425A 501(c)(3) and 501(c)(4) Orgs Engaged in Excess Benefit Transaction? Part IV, Line 25a 1
    0425B Become Aware that it Engaged in Excess Benefit Transaction? Part IV, Line 25b 1
    0426 Loan to or by a Current/Former Officer/Director? Part IV, Line 26 1
    0427 Provide Grant or Other? Part IV, Line 27 1
    0428A Transaction with Current/Former Officer? Part IV, Line 28a 1
    0428B Transaction with Family Member? Part IV, Line 28b 1
    0428C Transaction with Entity or Current/Former Officer? Part IV, Line 28c 1
    0429 Receive or Accrue more than $25,000 in Non-Cash? Part IV, Line 29 1
    0430 Receive or Accrue Contributions of Art? Part IV, Line 30 1
    0431 Liquidate, Terminate or Dissolve? Part IV, Line 31 1
    0432 Sell, Exchange, Dispose of? Part IV, Line 32 1
    0433 Own 100% of an Entity? Part IV, Line 33 1
    0434 Related to any Tax Exempt or Taxable Entity? Part IV, Line 34 1
    0435A Controlled Entity within 512(b)(13)? Part IV, Line 35a 1
    0435B Receive Payment or Engage in Transaction Within 512(b)(13)? Part IV, Line 35b 1
    0436 Make any Transfers? Part IV, Line 36 1
    0437 Conduct more than 5%? Part IV, Line 37 1
    0438 Complete Schedule O? Part IV, Line 38 1

Section 04
Invalid Conditions/
Correction Procedures

  1. These fields are invalid if they are not all 1, 2 or blank.

  2. 1 = yes, 2 = no, blank = blank or both boxes checked.

  3. Refer to the return to verify the entry. Correct any coding or transcription errors.

  4. See Exhibit 3.12.12-8 for additional information and IRI correspondence.

Section 05
Field Descriptions

  1. Listed below are the fields contained in Section 05 showing the field designator, title, and location on the return. Money Fields are Dollars Only and can be Positive or Negative.


    FIELD

    FIELD
    TITLE
    LINE No.
    990

    FIELD
    Length
    051A Number of Forms 1096 Part V, Line 1a 6
    051B Number of Forms W-2G Part V, Line 1b 6
    051C Comply with Backup Withholding Rules? Part V, Line 1c 1
    052A Number of Employees Reported on W-3? Part V, Line 2a 6
    052B File all Required Employment Returns? Part V, Line 2b 1
    053A Unrelated Business income <$1,000? Part V, Line 3a 1
    053B If Yes Has a 990-T been filed? Part V, Line 3b 1
    054A Maintain an Interest? Part V, Line 4a 1
    055A Party to a Prohibited Tax Shelter? Part V, Line 5a 1
    055B Taxable Party Notify ORG? Part V, Line 5b 1
    055C If Yes did ORG file Form 8886–T? Part V, Line 5c 1
    056A Annual Gross Receipts Normally <$100,000 Part V, Line 6a 1
    056B If Yes did ORG Include with Solicitations? Part V, Line 6b 1
    057A $75 Partly Contribution/Goods/Services Part V, Line 7a 1
    057B If Yes did ORG Notify Donor? Part V, Line 7b 1
    057C Sell, Exchange, or Otherwise Dispose of? Part V, Line 7c 1
    057D Number of Forms 8282? Part V, Line 7d 4
    057E Receive any Funds? Part V, Line 7e 1
    057F Pay Premiums? Part V, Line 7f 1
    057G Contributions of Qualified Intellectual Property? Part V, Line 7g 1
    057H Did ORG File Form 1098-C? Part V, Line 7h 1
    058 Sponsoring Orgs, 509(a)(3) Excess Business Holdings? Part V, Line 8 1
    059A Make Taxable Distributions Under 4966? Part V, Line 9a 1
    059B Make Distribution to Donor? Part V, Line 9b 1
    0510A Initiation Fees and Capital Contributions? Part V, Line 10a 13
    0510B Gross Receipts for Public use of Club Facilities Part V, Line 10b 13
    0511A Gross Income from Members or Shareholders? Part V, Line 11a 13
    0511B Gross Income from Other Sources Part V, Line 11b 13
    0512A 4947(a)(1) Filing 990 in lieu of 1041? Part V, Line 12a 1
    0512B Amount of Tax Exempt Interest Part V, Line 12b 13
    0513A Licensed to issue Qualified Health Plans Part V, Line 13a 1
    0513B Aggregate Amount of Reserves to Maintain Part V, Line 13b 15
    0513C Aggregate Amount of Reserves on Hand Part V, Line 13c 15
    0514A Receive Payments for Indoor Tanning Part V, Line 14a 1
    0514B Filed Form 720 to Report Payments Part V, Line 14b 1

Section 05
Invalid Conditions/
Correction Procedures

  1. These fields are invalid if they are not all numeric or blank. Yes/No questions are invalid if other than "1" , "2" or blank.

  2. Refer to the return to verify the entry. Correct any coding or transcription errors.

  3. For Yes/No questions, "1" = Yes, " 2 " = No, and blank = no box checked or both boxes checked.

  4. See Exhibit 3.12.12-8 for additional information and IRI correspondence.

  5. Fields 051A and 051B are invalid if not numeric and can have up to six characters. If any characters in these fields are not numeric delete the invalid characters.

Section 06
Field Descriptions

  1. Section 06 fields are located in Form 990 Part VI.

  2. Listed below are the fields contained in Section 06 showing the field designator, title, and location on the return:


    FIELD

    FIELD
    TITLE
    LINE No.
    990
    Field
    Length
    061A Voting Members of Governing Body Part VI, Section A, Line 1a 6
    061B Independent Voting Members Part VI, Section A, Line 1b 6
    062 Officer, Director, Trustee have Family Relationship? Part VI, Section A, Line 2 1
    063 Delegate Control over Management? Part VI, Section A, Line 3 1
    064 Make Significant Changes to ORG Docs? Part VI, Section A, Line 4 1
    065 Become aware of a Material Diversion? Part VI, Section A, Line 5 1
    066 Have Members or Stockholders? Part VI, Section A, Line 6 1
    067A Members, Stockholders or Other Persons who Elect? Part VI, Section A, Line 7a 1
    067B Decisions Subject to Approval By Members? Part VI, Section A, Line 7b 1
    0615A Determining Compensation for CEO, Executive Director? Part VI, Section B, Line 15a 1

Section 06
Invalid Conditions/
Correction Procedures

  1. Question Fields are invalid if other than "1" , "2" or blank.

  2. Refer to the return to determine the correct Question Code. Correct any coding or transcription errors

  3. Correct Question Codes are:

    1. 1—If the " yes" box is checked.

    2. 2—If the " no" box is checked.

    3. Blank—If neither box is checked, both boxes are checked or "not applicable" .

  4. Fields 061A and 061B are invalid if not numeric and can have up to six characters. If any characters in these fields are not numeric delete the invalid characters.

Section 07
Field Descriptions

  1. Section 07 fields are located in Form 990 Part VII.

  2. Listed below are the fields contained in Section 07 showing the field designator, title, and location on the return.


    FIELD

    FIELD
    TITLE
    LOCATION
    ON
    990

    FIELD
    LENGTH
    071BD Total Reportable Compensation from ORG. Part VII, Section A, Line 1d Col. (D) 13
    071BE Total Reportable Compensation from Related ORG. Part VII, Section A, Line 1d Col. (E) 13
    071BF Total Other Compensation from ORG and Related ORG. Part VII, Section A, Line 1d Col. (F) 13
    07A2 Total Individuals who Received <$100,000 Part VII, Section A, Line 2 6
    07B2 Total Independent Contractors who Received <$100,000 Part VII, Section B, Line 2 6
Section 07
Invalid Conditions/
Correction Procedures
  1. All fields are invalid if they are other than numeric or blank.

  2. Correct any coding or transcription errors.

  3. See Exhibit 3.12.12-8 for IRI Correspondence instructions.

  4. There is a programming problem that is being corrected. Fields 07A2 and 07B2 should be valid if blank. If a return falls out because these fields are blank, enter 6–9s to clear the error.

Section 08
Field Descriptions

  1. Section 08 fields are located in Form 990 Part VIII.

  2. All Section 08 fields are dollars only or numeric and may be either positive or negative.

  3. Listed below are the fields contained in Section 08 showing the field designator, title, and location on the return. All fields are 13 positions:

    FIELD
    FIELD
    TITLE
    LOCATION
    ON
    990

    FIELD
    LENGTH
    081HA Total Contributions, Gifts, Grants Part VIII, Line 1h, Col. (A) 13
    082A Program Service Revenue a Business Code Part VIII, Line 2a 6
    082AA Program Service Revenue a Total Revenue Part VIII, Line 2a Col. (A) 13
    082B Program Service Revenue b Business Code Part VIII, Line 2b 6
    082BA Program Service Revenue b Total Revenue Part VIII, Line 2b Col. (A) 13
    082C Program Service Revenue c Business Code Part VIII, Line 2c 6
    082CA Program Service Revenue c Total Revenue Part VIII, Line 2c Col. (A) 13
    082D Program Service Revenue d Business Code Part VIII, Line 2d 6
    082DA Program Service Revenue d Total Revenue Part VIII, Line 2d Col. (A) 13
    082E Program Service Revenue e Business Code Part VIII, Line 2e 6
    082EA Program Service Revenue e Total Revenue Part VIII, Line 2e Col. (A) 13
    08FA Program Service Revenue f Total Revenue Part VIII, Line 2f Col. (A) 13
    082G Program Service Revenue Total Part VIII, Line 2g 13
    083A Investment Income Part VIII, Line 3 Col. (A) 13
    084A Tax Exempt Bond Proceeds Part VIII, Line 4 Col. (A) 13
    085A Royalties Part VIII, Line 5 Col. (A) 13
    086AR Gross Rents-Real Part VIII, Line 6a (real) 13
    086AP Gross Rents-Personal Part VIII, Line 6a (pers) 13
    086BR Less Rental Expenses-Real Part VIII, Line 6b (real) 13
    086BP Less Rental Expenses-Personal Part VIII, Line 6b (pers) 13
    086CR Rental Income-Real Part VIII, Line 6c (real) 13
    <<<< Rental Income Underprint Amount 13
    086CP Rental Income-Personal Part VIII, Line 6c (pers) 13
    086DA Net Rental Income Part VIII, Line 6d Col. (A) 13
    <<<< Net Rental Income Underprint Amount 13
    087AS Gross Amount from Sales of Securities Part VIII, Line 7a (sec) 13
    087AO Gross Amount from Sales of Assets Other Part VIII, Line 7a (other) 13
    087BS Cost or Other Basis and Sales Securities Part VIII, Line 7b (sec) 13
    087BO Cost or Other Basis and Sales Other Part VIII, Line 7b (other) 13
    087CS Gain or Loss Securities Part VIII, Line 7c (sec) 13
    <<<< Gain or Loss Securities Underprint Amount 13
    087CO Gain or Loss Other Part VIII, Line 7c (other) 13
    <<<< Gain or Loss Other Underprint Amount 13
    087DA Net Gain or Loss Part VIII, Line 7d Col. (A) 13
    088A Gross Income from Fundraising Events Part VIII, Line 8a 13
    088B Less Direct Expenses Part VIII, Line 8b 13
    088CA Net Income or Loss from Fundraising Part VIII, Line 8a Col. (A) 13
    <<<< Net Income or Loss Underprint Amount 13
    089A Gross Income from Gaming Part VIII, Line 9a 13
    089B Less Direct Expenses Part VIII, Line 9b 13
    089CA Net Income/Loss from Gaming Part VIII, Line 9c Col. (A) 13
    <<<< Net Income/Loss from Gaming Underprint 13
    0810A Gross Sales from Inventory Part VIII, Line 10a 13
    0810B Less Cost of Goods Sold Part VIII, Line 10b 13
    0810C Net Income or Loss from Sales Part VIII, Line 10c 13
    <<<< Net Income or Loss from Sales Underprint 13
    0811A Miscellaneous Revenue a Business Code Part VIII, Line 11a 6
    08A11 Miscellaneous Revenue a Total Revenue Part VIII, Line 11a Col. (A) 13
    0811B Miscellaneous Revenue b Business Code Part VIII, Line 11b 6
    08B11 Miscellaneous Revenue b Total Revenue Part VIII, Line 11b Col. (A) 13
    0811C Miscellaneous Revenue c Business Code Part VIII, Line 11c 6
    08C11 Miscellaneous Revenue c Total Revenue Part VIII, Line 11c Col. (A) 13
    0811D Miscellaneous Revenue d Total Revenue Part VIII, Line 11d Col. (A) 13
    0811E Miscellaneous Revenue e Total Part VIII, Line 11e 13
    0812A Total Revenue Part VIII, Line 12 Col. (A) 13
    <<<< Total Revenue Underprint 13
Section 08
Invalid Conditions/
Correction Procedures
  1. These fields are invalid if they are not all numeric or blank.

  2. Refer to the return to verify the entries. Correct any coding or transcription errors.

    Note:

    Remove any non-numeric entries in the Business Code Fields, such as period(s). Also delete the Business Code Fields if they are less than six digits/numeric and it's not a misplaced entry.

  3. See Exhibit 3.12.12-8 for IRI correspondence procedures.

Section 09
Field Descriptions

  1. Section 09 fields are located 990 Part IX.

  2. Listed below are the fields contained in Section 09 showing the field designator, title, and location on the return. All fields are dollars only:

    FIELD
    FIELD
    TITLE
    LOCATION
    ON Form 990

    FIELD
    LENGTH
    091A Grants to Gov./Orgs in U.S. Part IX, Line 1 Col. (A) 13
    092A Grants and Other Assistance in U.S. Part IX, Line 2 Col. (A) 13
    093A Grants and Other Assistance Outside U.S. Part IX, Line 3 Col. (A) 13
    094A Benefits Paid to or for Members Part IX, Line 4 Col. (A) 13
    095A Compensation of Current Officers, Directors Part IX, Line 5 Col. (A) 13
    096A Compensation to Disqualified Persons Part IX, Line 6 Col. (A) 13
    097A Other Salaries and Wages Part IX, Line 7 Col. (A) 13
    098A Pension Plan Contributions Part IX, Line 8 Col. (A) 13
    099A Other Employee Benefits Part IX, Line 9 Col. (A) 13
    0910A Payroll Taxes Part IX, Line 10 Col. (A) 13
    0911A Fees for Services Management Part IX, Line 11a Col. (A) 13
    0911B Fees for Services Legal Part IX, Line 11b Col. (A) 13
    0911C Fees for Services Accounting Part IX, Line 11c Col. (A) 13
    0911D Fees for Services Lobbying Part IX, Line 11d Col. (A) 13
    0911E Fees for services Professional Fundraising Part IX, Line 11e Col. (A) 13
    0911F Fees for Services Investment Management Part IX, Line 11f Col. (A) 13
    0911G Fees for Services Other Part IX, Line 11g Col. (A) 13
    0912A Advertising Part IX, Line 12 Col. (A) 13
    0913A Office Expenses Part IX, Line 13 Col. (A) 13
    0914A Information Technology Part IX, Line 14 Col. (A) 13
    0915A Royalties Part IX, Line 15 Col. (A) 13
    0916A Occupancy Part IX, Line 16 Col. (A) 13
    0917A Travel Part IX, Line 17 Col. (A) 13
    0918A Payments of Travel or Entertainment Part IX, Line 18 Col. (A) 13
    0919A Conferences, Conventions and Meetings Part IX, Line 19 Col. (A) 13
    0920A Interest Part IX, Line 20 Col. (A) 13
    0921A Payments to Affiliates Part IX, Line 21 Col. (A) 13
    0922A Depreciation, Depletion, ect, Part IX, Line 22 Col. (A) 13
    0923A Insurance Part IX, Line 23 Col. (A) 13
    0924A Other Expenses a Part IX, Line 24a Col. (A) 13
    0924B Other Expenses b Part IX, Line 24b Col. (A) 13
    0924C Other Expenses c Part IX, Line 24c Col. (A) 13
    0924D Other Expenses d Part IX, Line 24d Col. (A) 13
    0924E Other Expenses e Part IX, Line 24e Col. (A) 13
    0924F Other Expenses f Part IX, Line 24f Col. (A) 13
    0925A Total functional Expenses Part IX, Line 25 Col. (A) 13
    <<<< Total Functional Expenses Underprint 13
Section 09
Invalid Conditions/
Correction Procedures
  1. Section 09 fields are all dollars and can be positive or negative

  2. Refer to the return to determine the correct entry.

  3. See Exhibit 3.12.12-8 for IRI correspondence instructions.

Section 10
Field Descriptions

  1. All of the fields in Section 10 are dollars only and are positive or negative.

  2. Listed below are the fields contained in Section 10 showing the field designator, title, location on the return, and maximum length:

    FIELD
    NAME

    FIELD
    TITLE

    LINE
    NO.
    990
    MAX.
    LENGTH
    101B Cash Non Interest Part X, Line 1, Col. (B) 13
    102B Savings and Temp. Cash Investments Part X, Line 2, Col. (B) 13
    103B Pledges and Grants Receivable Part X, Line 3, Col. (B) 13
    104B Accounts Receivable Net Part X, Line 4, Col. (B) 13
    105B Receivables from Current and Former Part X, Line 5, Col. (B) 13
    106B Receivables from Disqualified Part X, Line 6, Col. (B) 13
    107B Notes and Loans Receivable Part X, Line 7, Col. (B) 13
    108B Inventories for Sale or Use Part X, Line 8, Col. (B) 13
    109B Prepaid Expenses Part X, Line 9, Col. (B) 13
    1010C Land Build. and Equipment Part X, Line 10c, Col. (B) 13
    1011B Investments Publicly Traded Part X, Line 11, Col. (B) 13
    1012B Investments Other Part X, Line 12, Col. (B) 13
    1013B Investments Program Related Part X, Line 13, Col. (B) 13
    1014B Intangible Assets Part X, Line 14, Col. (B) 13
    1015B Other Assets Part X, Line 15, Col. (B) 13
    1016A Total Assets (BOY) Part X, Line 16, Col. (A) 13
    1016B Total Assets (EOY) Part X, Line 16, Col. (B) 13
    1017B Accounts Payable and Secured Expenses Part X, Line 17, Col. (B) 13
    1018B Grants Payable Part X, Line 18, Col. (B) 13
    1019B Deferred Revenue Part X, Line 19, Col. (B) 13
    1020B Tax Exempt Bond Liabilities Part X, Line 20, Col. (B) 13
    1021B Escrow Account Liability Part X, Line 21, Col. (B) 13
    1022B Payable to Current Part X, Line 22, Col. (B) 13
    1023B Secured Mortgages and Notes Part X, Line 23, Col. (B) 13
    1024B Unsecured Notes and Loans Payable Part X, Line 24, Col. (B) 13
    1025B Other Liabilities Part X, Line 25, Col. (B) 13
    1026A Total Liabilities (BOY) Part X, Line 26, Col. (A) 13
    1026B Total Liabilities (EOY) Part X, Line 26, Col. (B) 13
    1027B Unrestricted Net Assets Part X, Line 27, Col. (B) 13
    1028B Temp. Restricted Net Assets Part X, Line 28, Col. (B) 13
    1029B Per. Restricted Net Assets Part X, Line 29, Col. (B) 13
    1030B Capital Stock or Trust Part X, Line 30, Col. (B) 13
    1031B Paid in or Capital Surplus Part X, Line 31, Col. (B) 13
    1032B Retained Earnings Part X, Line 32, Col. (B) 13
    1033A Total Net Assets or Fund Balances (BOY) Part X, Line 33, Col. (A) 13
    <<<< Total Net Assets or Fund Balances (BOY) Underprint 13
    1033B Total Net Assets or Fund Balances (EOY) Part X, Line 33, Col. (B) 13
    <<<< Total Net Assets or Fund Balances (EOY) Underprint 13
    1034B Total Liabilities and Net Assets/Fund Balances Part X, Line 34, Col. (B) 13
Section 10
Invalid Conditions/
Correction Procedures
  1. These fields are invalid if they are not all numeric or blank.

  2. Refer to the return to verify the entry. Correct any coding or transcription errors.

Section 11
Field Descriptions

  1. All of the fields in Section 11 are dollars only and are positive or negative.

  2. Listed below are the fields contained in Section 11 showing the field designator, title, location on the return, and maximum length:




    FIELD



    FIELD TITLE


    LINE
    NO.

    990
    MAX.
    LENGTH
    11TO Type of Organization Schedule A, Part I, Line 11, a – d checkbox 1
    11E Written Determination Type I, II or III Schedule A, Part I, Line 11e checkbox 1
    11F Number of Supported Organizations Schedule A, Part I, Line 11f 3
    11GA2 EIN A Schedule A, Part I, Line 12g, Row A Column (ii) 9
    11GA3 Type of Organization Schedule A, Part I, Line 12g, Row A, Column (iii) 1
    11GA4 Listed in Governing Document Schedule A, Part I, Line 12g, Row A, Column (iv) 1
    11GA5 Amount of Support A Schedule A, Part I, Line 12g, Row A, Column (v) 13
    11GB2 EIN B Schedule A, Part I, Line 12g, Row B Column (ii) 9
    11GB3 Type of Organization Schedule A, Part I, Line 12g, Row B, Column (iii) 1
    11GB4 Listed in Governing Document Schedule A, Part I, Line 12g, Row B, Column (iv) 1
    11GB5 Amount of Support B Schedule A, Part I, Line 12g, Row B, Column (v) 13
    11GC2 EIN C Schedule A, Part I, Line 12g, Row C, Column (ii) 9
    11GC3 Type of Organization Schedule A, Part I, Line 12g, Row C, Column (iii) 1
    11GC4 Listed in Governing Document Schedule A, Part I, Line 12, Row C, Column (iv) 1
    11GC5 Amount of Support C Schedule A, Part I, Line 12g, Row C, Column (v) 13
    11GD2 EIN D Schedule A, Part I, Line 12g, Row D, Column (ii) 9
    11GD3 Type of Organization Schedule A, Part I, Line 12g, Row D Column (iii) 1
    11GD4 Listed in Governing Document Schedule A, Part I, Line 12g, Row D, Column (iv) 1
    11GD5 Amount of Support D Schedule A, Part I, Line 12g, Row D, Column (v) 13
    11GE2 EIN E Schedule A, Part I, Line 12g, Row E, Column (ii) 9
    11GE3 Type of Organization Schedule A, Part I, Line 12g, Row E Column (iii) 1
    11GE4 Listed in Governing Document Schedule A, Part I, Line 12g, Row E, Column (iv) 1
    11GE5 Amount of Support E Schedule A, Part I, Line 12g, Row E, Column (v) 13
    11TOT Total Schedule A, Part I, Line 12g, Total, Column (v) 13
    1111G Total Number of Organizations Sch. A, Part I, Line 12G(vi) Total 6
    11G11 Total Amount of Support Sch. A, Part I, Line 12G (vi) Total 13
    111F Gifts, Grants, Contributions - 170 Amount Sch. A, Part II, Line 1 Col. (F) 13
    112F Tax Revenues Levied Sch. A, Part II, Line 2 Col. (F) 13
    113F Value of Services 170 Amount Sch. A, Part II, Line 3 Col. (F) 13
    114F Total 170 Amount Sch. A, Part II, Line 4 Col. (F) 13
    <<<< Total 170 Amount Underprint 13
    115F Exceeds 2% 170 Sch. A, Part II, Line 5 Col. (F) 13
    116F Public Support 170 Sch. A, Part II, Line 6 Col. (F) 13
    117F Amount from Line 4 Sch. A, Part II, Line 7 Col. (F) 13
    118F Gross Income from Interest 170 Sch. A, Part II, Line 8 Col. (F) 13
    119F Net Income from Unrelated Business 170 Sch. A, Part II, Line 9 Col. (F) 13
    1110F Other Income 170 Sch. A, Part II, Line 10 Col. (F) 13
    1111F Total Support 170 Sch. A, Part II, Line 11 Col. (F) 13
    <<<< Total Support 170 Underprint 13
    1112 Receipts from Related Activities 170 Sch. A, Part II, Line 12 Col. (F) 13
    1113 First 5 Years Checkbox 170 Sch. A, Part II, Line 13 Col. (F) CKBX 1
    1116A 33 1/3% Test Current Year Checkbox 170 Sch. A, Part II, Line 16a Col. (F) CKBX 1
    1116B 33 1/3 Test Prior Year Checkbox 170 Sch. A, Part II, Line 16b Col. (F) CKBX 1(
    1117A Current Facts Checkbox 170 Sch. A, Part II, Line 17a Col. (F) CKBX 1
    1117B Prior Facts Checkbox 170 Sch. A, Part II, Line 17b Col. (F) CKBX 1
    1118 Private Foundation Checkbox Sch. A, Part II, Line 18 Col. (F) CKBX 1
Section 11
Invalid Conditions/
Correction Procedures
  1. Dollar fields are invalid if they are not all numeric or blank.

  2. Yes/no questions are invalid if not "1" , "2" , or Blank.

  3. Fields 11GA3, 11GB3, 11GC3 11GD3, and 11GE3 are invalid if not "1" through "9" or Blank. If an invalid entry is present and the correct entry cannot be determined from return or the box checked on Part I, Lines 1–9, Blank Part I, Lines 1-9 to clear the field error. On MEF returns just Blank Part I, Lines 1-9. if they error out.

  4. Refer to the return to verify the entry. If the checkboxes are checked it should be a 1, if not blank the field.

  5. Field 11TO must be present if box 11 is checked. It is valid as a 1-4 based on which box is marked on Schedule A, Part I, Line 11 boxes a through d. See Error Code 955.

  6. Fields 11GA4, 11GB4, 11GC4 11GD4, and 11GE4 may be transmitted to GMF as a "0" on MEF returns when the filer checks the No box. Change the "0" to a "2" if this occurs.

  7. #2014 and subsequent Revision - Line 11g Column (iii) A,B,C,D, E, Type of Organization: If other than a single numeric 1 - 9 only is present clear the information present and edit based on the following:

    If Description or information on Line 11g Column (iii) is Then edit on Line 11g, Column (iii) A, B, C, D, E
    Church, convention of churches or 170(b)(1)(A)(i) 1
    School or 170(b)(1)(A)(ii) 2
    Hospital or 170(b)(1)(A)(iii) 3
    Medical Research 4
    Operated for the benefit of a college, university or governmental unit or 170(b)(1)(A)(iv) 5
    Federal, state or local governmental unit or 170(b)(1)(A)(v) 6
    Support from a governmental unit or public or 170(b)(1)(A)(vi) 7
    Community trust 8
    More than 33% support or 509(a)(2) 9
    None of the above or unable to determine Clear the information present in 1-9

Section 12
Field Descriptions

  1. Listed below are the fields contained in Section 12 showing the field designator, title, location on the return, and maximum length:




    FIELD



    FIELD TITLE


    LINE
    NO.

    990
    MAX.
    LENGTH
    121F Gifts, Grants, Contributions 509 Sch. A, Part III, Line 1 Col. (F) 13
    122F Gross Receipts from Admissions 509 Sch. A, Part III, Line 2 Col. (F) 13
    123F Gross Receipts from Activities 509 Sch. A, Part III, Line 3 Col. (F) 13
    124F Tax Revenues Levied 509 Sch. A, Part III, Line 4 Col. (F) 13
    125F Value of Services 509 Sch. A, Part III, Line 5 Col. (F) 13
    126F Total 509 Sch. A, Part III, Line 6 Col. (F) 13
    <<<< Total 509 Underprint 13
    127AF Received from Disqualified 509 Sch. A, Part III, Line 7a Col. (F) 13
    127BF Received from Other 509 Sch. A, Part III, Line 7b Col. (F) 13
    127CF Total of 7a and 7b 509 Sch. A, Part III, Line 7c Col. (F) 13
    128F Public Support 509 Sch. A, Part III, Line 8 Col. (F) 13
    129F Amount from Line 6 Sch. A, Part III, Line 9 Col. (F) 13
    1210A Gross Income from Interest Sch. A, Part III, Line 10a Col. (F) 13
    1210B Unrelated Business Taxable Income 509 Sch. A, Part III, Line 10b Col. (F) 13
    1210C Total of 10a and 10b 509 Sch. A, Part III, Line 10c Col. (F) 13
    1211F Net Income from Unrelated Activity 509 Sch. A, Part III, Line 11 Col. (F) 13
    1212F Other Income 509 Sch. A, Part III, Line 12 Col. (F) 13
    1213F Total Support 509 Sch. A, Part III, Line 13 Col. (F) 13
    <<<< Total Support 509 Underprint 13
    1214 First Five Years Checkbox 509 Sch. A, Part III, Line 14 Col. (F) CKBX 1
    1219A 33 1/3 Test Current Year 509 Sch. A, Part III, Line 19a Col. (F) CKBX 1
    1219B 33 1/3 Test Prior Year 509 Sch. A, Part III, Line 19b Col. (F) CKBX 1
    1220 Private Foundation Checkbox 509 Sch. A, Part III, Line 20 Col. (F) CKBX 1
    12P4A Part IV, Section A, Data Present Schedule A Part IV, Section A 1
    12P4B Part IV, Section B, Data Present Schedule A Part IV, Section B 1
    12P4C Part IV, Section C, Data Present Schedule A Part IV, Section C 1
    12P4D Part IV, Section D, Data Present Schedule A Part IV, Section D 1
    12P4E Part IV, Section E, Data Present Schedule A Part IV, Section E 1
    12E3C Excess Distributions C Schedule A Part V, Section E, Line 3c 13
    12E3D Excess Distributions D Schedule A Part V, Section E, Line 3d 13
    12E3E Excess Distributions E Schedule A Part V, Section E, Line 3e 13
    12E8C Excess Distributions Breakdown C Schedule A Part V, Section E, Line 8c 13
    12E8D Excess Distributions Breakdown D Schedule A Part V, Section E, Line 8d 13
    12E8E Excess Distributions Breakdown E Schedule A Part V, Section E, Line 8e 13
Section 12
Invalid Conditions/
Correction Procedures
  1. Dollar fields are invalid if they are not all numeric or blank.

  2. Checkboxes are invalid if not "1" , or blank.

  3. Refer to the return to verify the entry. If the checkboxes are checked it should be a 1, if not blank the field.

  4. Fields 12P4A, 12P4B, 124PC, 124PD and 124PE valid entries are 1 or blank.

Section 13
Field Descriptions

  1. Listed below are the fields contained in Section 13 showing the field designator, title, location on the return, and maximum length:




    FIELD



    FIELD TITLE



    LOCATION



    MAX.
    LENGTH
    13CI2 Political Expenditures Sch. C, Part I-A, Line 2 13
    13D1A Total Number at EOY Sch. D, Part I, Line 1 Col. (A) 6
    13D2A Contributions To Sch. D, Part I, Line 2 Col. (A) 6
    13D3A Grants Form Sch. D, Part I, Line 3 Col. (A) 6
    13D4A Aggregate Value Sch. D, Part I, Line 4 Col. (A) 13
    13D5 Inform all Donors Sch. D, Part I, Line 5 1
    13D6 Inform all Grantees Sch. D, Part I, Line 6 1
Section 13
Invalid Conditions/
Correction Procedures
  1. Dollar fields are invalid if they are not all numeric or blank.

  2. Checkboxes are invalid if not "1" , " 2" or blank.

  3. Refer to the return to verify the entry. Correct any coding or transcription errors.

Section 14
Field Descriptions

  1. Listed below are the fields contained in Section 14 showing the field designator, title, location on the return, and maximum length:




    FIELD



    FIELD TITLE


    LINE
    NO.

    Sch. H
    MAX.
    LENGTH
    141A Financial Assistance Schedule H, Part I, Line 1a. 1
    141B Written Policy Schedule H, Part I, Line 1b 1
    142 Best Describes Schedule H, Part I., Line 2 1
    143A FPG Used Schedule H, Part I, Line 3a 1
    143AP FPG Percent Schedule H, Part I, Line 3a percent line. 3
    143B FPG Discounted Care Schedule H, Part I, Line 3b. 1
    143BP FPG Discounted Care Percent Schedule H, Part I, Line 3b percent line 3
    144 Applied to Largest Number of Patients Schedule H, Part I, Line 4 1
    145A Budget Amounts for Free or Discounted Schedule H, Part I, Line 5a 1
    145B Exceed Budget Amount Schedule H, Part I, Line 5b 1
    145C Unable to Provide Free or Discounted Care Schedule H, Part I, Line 5c 1
    146A Prepare A Community Benefit Report Schedule H, Part I, Line 6a 1
    146B Available to Public Schedule H, Part I, Line 6b 1
    147AC Financial Assistance C Schedule H, Part I, Line 7a, Column (c) 13
    147AD Financial D Schedule H, Part I, Line 7a, Column (d) 13
    147AE Financial Assistance at Cost Net Community Sch. H, Part I, Line 7a, Col. (e) 13
    147AF Financial Assistance at Cost Percent Sch. H, Part I, Line 7a Col. (f) 3
    147BC Medicaid C Schedule H, Part I, Line 7b, Column (c) 13
    147BD Medicaid D Schedule H, Part I, Line 7b, Column (d) 13
    147BE Unreimbursed Medicaid Net Community Sch. H, Part I, Line 7b Col. (e) 13
    147BF Unreimbursed Medicaid Percent Sch. H, Part I, Line 7b Col. (f) 3
    147CC Cost Of Other Means Tested C Schedule H, Part I, Line 7c, Column (c) 13
    147CD Cost Of Other Means Tested D Schedule H, Part I, Line 7c, Column (d) 13
    147CE Unreimbursed Costs - Other Net Community Sch. H, Part I, Line 7c Col. (e) 13
    147CF Unreimbursed Costs-Other Net Percent Sch. H, Part I, Line 7c Col. (f) 3
    147DC Financial Assistance Total C Schedule H, Part I, Line 7d, Column (c) 13
    147DD Financial Assistance Total D Schedule H, Part I, Line 7d, Column (d) 13
    147DE Total Financial Assistance Net Community Sch. H, Part I, Line 7d, Col. (e) 13
    147DF Total Financial Assistance Percent Sch. H, Part I, Line 7d Col. (f) 3
    14H31 Report Bad Debt Expense Sch. H, Part III, Line 1 1
    14H32 Bad Debt Expense Amount Sch. H, Part III, Line 2 13
    14H33 Estimated Bad Debt Amount Sch. H, Part III, Line 3 13
    14H35 Revenue from Medicare Sch. H, Part III, Line 5 13
    14H36 Medicare Allowable Costs Sch. H, Part III, Line 6 13
    14H37 Medicare Surplus or Shortfall Sch. H, Part III, Line 7 13
    14H38 Costing Methodology or Source Code Sch. H, Part III, Edited to the Right of the Checkboxes at the bottom of Line 8 1
    1439A Written Debt Collection Policy Sch. H, Part III, Line 9a 1
    1439B Collection Policy Contain Provision Sch. H, Part III, Line 9b 1
    14ATL How many Hospitals Facilities did Organization Operate? Sch. H, Part V, Section A, Top Left Box, Hospital Facilities 4
Section 14
Invalid Conditions/
Correction Procedures
  1. Dollar fields are invalid if they are not all numeric or blank.

  2. Checkboxes are invalid if not "1" , " 2" , or blank.

  3. Field 14H38 is invalid if not a "1" , first box checked "2" second box checked or "3" third box checked or blank.

  4. Questions are invalid if not "1" , "2" or blank.

  5. Refer to the return to verify the entry. Correct any coding or transcription errors.

Section 15
Field Descriptions

  1. Listed below are the fields contained in Section 15 showing the field designator, title, location on the return, and maximum length:

  2. Sections 15 through31 are repeats of Schedule H, Part V. There are two sections for each Part V and we will transcribe up to five Schedule H, Part V's. Each Organization must submit a Schedule H, Part V for each facility they operate.




    FIELD



    FIELD TITLE


    LINE
    NO.

    Sch. H
    MAX.
    LENGTH
    157EC Community Health Improvement Schedule H, Part I, Line 7e, Column (c) 13
    157ED Community Health Improvement D Schedule H, Part I, Line 7e, Column (d) 13
    157EE Community Health Improvement E Schedule H, Part I, Line 7e, Column (e) 13
    157EF Community Health Improvement Percent Schedule H, Part I, Line 7e, Column (f) 3
    157FC Health Professions C Schedule H, Part I, Line 7f, Column (c) 13
    157FD Health Professions D Schedule H, Part I, Line 7f, Column (d) 13
    157FE Health Professions E Schedule H, Part I, Line 7f, Column (e) 13
    157FF Health Professions Percent Schedule H, Part I, Line 7f, Column (f) 3
    157GC Subsidized Health Services C Schedule H, Part I, Line 7g, Column (c) 13
    157GD Subsidized Health Services D Schedule H, Part I, Line 7g, Column (d) 13
    157GE Subsidized Health Services E Schedule H, Part I, Line 7g, Column (e) 13
    157GF Subsidized Health Services Percent Schedule H, Part I, Line 7g, Column (f) 3
    157HC Research C Schedule H, Part I, Line 7h, Column (c) 13
    157HD Research D Schedule H, Part I, Line 7h, Column (d) 13
    157HE Research E Schedule H, Part I, Line 7h, Column (e) 13
    157HF Research Percent Schedule H, Part I, Line 7h, Column (f) 3
    157IC Cash & Contributions C Schedule H, Part I, Line 7i, Column (c) 13
    157ID Cash & Contributions D Schedule H, Part I, Line 7i, Column (d) 13
    157IE Cash & Contributions E Schedule H, Part I, Line 7i, Column (e) 13
    157IF Cash & Contributions Percent Schedule H, Part I, Line 7i, Column (f) 3
    157JC Total Other Benefits C Schedule H, Part I, Line 7j, Column (c) 13
    157JD Total Other Benefits D Schedule H, Part I, Line 7j, Column (d) 13
    157JE Total Other Benefits E Schedule H, Part I, Line 7j, Column (e) 13
    157JF Total Other Benefits Percent Schedule H, Part I, Line 7j, Column (f) 3
    157KC Total C Schedule H, Part I, Line 7k, Column (c) 13
    157KD Total D Schedule H, Part I, Line 7k, Column (d) 13
    157KE Total E Schedule H, Part I, Line 7k, Column (e) 13
    157KF Total F Percent Schedule H, Part I, Line 7k, Column (f) 3
Section 15
Invalid Conditions/
Correction Procedures
  1. Refer to the return to verify the entry. Correct any coding or transcription errors.

Section 16
Field Descriptions

  1. Listed below are the fields contained in Section 16 showing the field designator, title, location on the return, and maximum length:




    FIELD



    FIELD TITLE


    LINE
    NO.

    Sch. H
    MAX.
    LENGTH
    1610E Total Net Community Schedule H, Part II, Line 10, Column (e) 13
    1610F Total Percent of Expense Schedule H, Part II, Line 10, Column (f) 3
    1631 Report Bad Debt Expense Schedule H, Part III, Line 1 1
    1632 Bad Debt Expense Amount Schedule H, Part III, Line 2 13
    1633 Estimated Bad Debt Expense Amount Schedule H, Part III, Line 3 13
    1635 Revenue from Medicare Schedule H, Part III, Line 5 13
    1636 Medicare Allowable Costs Schedule H, Part III, Line 6 13
    1637 Medicare Surplus or Shortfall Schedule H, Part III, Line 7 13
    1638R Costing Methodology or Source Code Schedule H, part III, Line 8, right 1
    169A Written Debt Collection Policy Schedule H, part III, Line 9a 1
    169B Collection Policy Contain Provisions Schedule H, part III, Line 9b 1
    164RM Part IV Code Schedule H, Part IV, right margin 1
    16ATL How many hospitals did the organization operate Schedule H, Part V, Section A, How many Hospitals Line 4
    16CI Part V Sections C Indicator Code Schedule H, Part V, Section C, Indicator Code, Right Margin 1
    16DTL Part V Sections D Non-Hospital Facilities Count Schedule H, Part V, Section D, Non-Hospital Facilities, Right Margin 4
    16DI Data Present Indicator Schedule H, Part V, Section D, Right Margin 1
Section 16
Invalid Conditions/
Correction procedures
  1. Checkboxes are invalid if not "1" or blank.

  2. All yes/no questions are invalid if not "1" , "2" or Blank.

  3. Refer to the return to verify the entry. Correct any coding or transcription errors.

Section 17
Field Descriptions

  1. Listed below are the fields contained in Section 17 showing the field designator, title, location on the return, and maximum length




    FIELD



    FIELD TITLE


    LINE
    NO.

    Sch. H
    MAX.
    LENGTH
    17NM1 Name of Facility (part 1) Schedule H, Part V, Section B, Top Portion 20
    17NM2 Name of Facility (continued in part 2) 15
    17ICD Section B Identification Number Code Schedule H, Part V, Section B Edited code 1
    17LNN Line Number reference to section A (valid 2013 and prior ) (prior 2014-Schedule H, Part V, Section B, line number of hospital) 3
    171 Licensed Register State Schedule H, Part V, Section B, Line 1 1
    172 Hospital Acquired in Current Year Schedule H, Part V, Section B, Line 2 2
    173 Hospital Conducted CHNA Schedule H, Part V, Section B, Line 3 (prior 2014 - Old line 1) 1
    173A Definition of Community Served Schedule H, Part V, Section B, Line 3a (prior 2014 - Old line 1a) 1
    173B Demographics of Community Schedule H, Part V, Section B, Line 3b (prior 2014 - Old line 1b) 1
    173C Existing Health Care and Resources Schedule H, Part V, Section B, Line 3c (prior 2014 - Old line 1c) 1
    173D How Data was Obtained Schedule H, Part V, Section B, Line 3d (prior 2014 - Old line 1d) 1
    173E Health Needs of Community Schedule H, Part V, Section B, Line 3e (prior 2014 - Old line 1e) 1
    173F Primary and Chronic Disease Schedule H, Part V, Section B, Line 3f (prior 2014 - Old line 1f) 1
    173G Identifying and Prioritizing Health Needs Schedule H, Part V, Section B, Line 3g (prior 2014 - Old line 1g) 1
    173H Consulting with Persons Representing Schedule H, Part V, Section B, Line 3h (prior 2014 - Old line 1h) 1
    173I Significant Health Needs Identified in the hospital facilities CHNA(s) Schedule H, Part V, Section B, Line 3i (prior 2014 - Old line 1i) 1
    173J Other Schedule H, Part V, Section B, Line 3j (prior 2014 - Old line 1j) 1
    174 Tax Year CHNA Conducted Schedule H, Part V, Section B, Line 4 (prior 2014 - Old line 2) 2
    175 Hospital Facility Take Into Account Input Schedule H, Part V, Section B, Line 5 (prior 2014 - Old line 3) 1
    176A CHNA Conducted with One or More Hospital Facilities Schedule H, Part V, Section B, Line 6a (prior 2014 - Old line 4) 1
    176B CHNA Conducted with One or More Organizations Other than Hospital Facilities Schedule H, Part V, Section B, Line 6b 1
    177 Widely Available to Public Schedule H, Part V, Section B, Line 7 (prior 2014 - Old line 5) 1
    177A Hospital Website Schedule H, Part V, Section B, Line 7a (prior 2014 - Old line 5a) 1
    177B Other Website Schedule H, Part V, Section B, Line 7b 1
    177C Available Upon Request Schedule H, Part V, Section B, Line 7c (prior 2014 - Old line 5c) 1
    177D Other Schedule H, Part V, Section B, Line 7d (prior 2014 - Old line 5d) 1
    17O6A Facility addressed needs adopt (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6a) 1
    17O6B Facility addressed needs execution (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6b) 1
    17O6C Facility addressed needs development (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6c) 1
    17O6D Facility addressed needs part in execution (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6d) 1
    17O6E Facility addressed needs inclusion (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6e) 1
    17O6F Facility addressed needs budget (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6f) 1
    17O6G Facility addressed needs prioritization (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6g) 1
    17O6H Facility addressed needs services (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6h) 1
    17O6I Facility addressed needs other (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6i) 1
    17OL7 Addressed needs identified (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 7) 1
Section 17
Invalid Conditions/
Correction Procedures
  1. Checkboxes are invalid if not "1" or blank.

  2. All yes/no questions are invalid if not "1" , "2" or Blank.

  3. Refer to the return to verify the entry. Correct any coding or transcription errors.

Section 18
Field Descriptions

  1. Listed below are the fields contained in Section 18 showing the field designator, title, location on the return, and maximum length:




    FIELD



    FIELD TITLE


    LINE
    NO.

    Sch. H
    MAX.
    LENGTH
    188 Adopt Implementation Strategy Schedule H, Part V, Section B, Line 8 1
    189 Tax Year Strategy Implemented Schedule H, Part V, Section B, Line 9 1
    1810 Strategy Posted on Website Schedule H, Part V, Section B, Line 10 1
    1810A URL Present Indicator Schedule H, Part V, Section B, Line 10a 1
    1810B Strategy Attached Schedule H, Part V, Section B, Line 10b 1
    1812A Excise Tax Under 4959 Schedule H, Part V, Section B, Line 12a (prior 2014 - Old line 8a) 1
    1812B Did Organization File 4720 Schedule H, Part V, Section B, Line 12b (prior 2014 - Old line 8b) 1
    1812C 4959 Tax Reported Schedule H, Part V, Section B, Line 12c (prior 2014 - Old line 8c) 15
    1813 Explained Eligibility Criteria Schedule H, Part V, Section B, Line 13 (prior 2014 - Old line 9) 1
    1813A Uses Federal Poverty Guidelines Free Care Schedule H, Part V, Section B, Line 13a (prior 2014 - Old line 10) 1
    18A1P Free Care Percentage Schedule H, Part V, Section B, Line 13a, 1st percentage. (prior 2014 - Old line 10%) 3
    18O11 Use FPG Discounted care (valid 2013 and prior) Schedule H, Part V, Section B, old Line 11) 1
    18A2P Discounted Care Percentage Schedule H, Part V, Section B, Line 13a, 2nd percentage. (prior 2014 - Old line 11%) 3
    18O12 Explained basis for calculating charged (valid 2013 and prior) Schedule H, Part V, Section B, old Line 11) 1
    1813B Income Level Other than FPG Schedule H, Part V, Section B, Line 13b (prior 2014 - Old line 12a) 1
    1813C Asset Level Schedule H, Part V, Section B, Line 13c (prior 2014 - Old line 12b) 1
    1813D Medical Indigency Schedule H, Part V, Section B, Line 13d (prior 2014 - Old line 12c) 1
    1813E Insurance Status Schedule H, Part V, Section B, Line 13e (prior 2014 - Old line 12d) 1
    1813F Underinsurance Status Schedule H, Part V, Section B, Line 13f (prior 2014 - Old line 12e) 1
    18OLF Basis calculating Medicaid/Medicare (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 12f) 1
    18OLG Basis calculating State Regulation (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 12g) 1
    1813G Residency Schedule H, Part V, Section B, Line 13g 1
    1813H Other Schedule H, Part V, Section B, Line 13h (prior 2014 - Old line 12i) 1
    1814 Calculating Amounts Charged to Patient Schedule H, Part V, Section B, Line 14 1
    1815 Explained the Method for Applying Financial Assistance Schedule H, Part V, Section B, Line 15 (prior 2014 - Old line 13) 1
    1815A Information Hospital Required on Application Schedule H, Part V, Section B, Line 15a 1
    1815B Supporting Information Required on Application Schedule H, Part V, Section B, Line 15b 1
    1815C Contact Information Schedule H, Part V, Section B, Line 15c 1
    1815D Contact Information Sources of Financial Assistance Schedule H, Part V, Section B, Line 15d 1
    1815E Other Schedule H, Part V, Section B, Line 15e 1
    1816 Was Widely Publicized Schedule H, Part V, Section B, Line 16. (prior 2014 - Old line 14) 1
    1816A FAP Available on Website Schedule H, Part V, Section B, Line 16a 1
    1816B FAP Application on Website Schedule H, Part V, Section B, Line 16b 1
    1816C Plain Language Summary Schedule H, Part V, Section B, Line 16c 1
    1816D FAP Available on Request Schedule H, Part V, Section B, Line 16d 1
    1816E FAP Application Form Upon Request Schedule H, Part V, Section B, Line 16e 1
    1816F Plain Language FAP Available Schedule H, Part V, Section B, Line 16f 1
    1816G Individuals Notified about FAP Schedule H, Part V, Section B, Line 16g 1
    1816H FAP Customers Notified Schedule H, Part V, Section B, Line 16h 1
    1816I FAP Translated into Primary Language of LEP Schedule H, Part V, Section B, Line 16i 1
    1816J Other Schedule H, Part V, Section B, Line 16j 1
    18O4A Policy posted on website (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14a) 1
    18O4B Policy attached billing (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14b) 1
    18O4C Policy posted in room (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14c) 1
    18O4D Policy posted in admin offices (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14d) 1
    18O4E Policy provided (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14e) 1
    18O4F Policy upon request (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14f) 1
    18O4G Policy other method (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14g) 1
Section 18
Invalid Conditions/
Correction Procedures
  1. Checkboxes are invalid if not "1" or blank.

  2. All yes/no questions are invalid if not "1" , "2" or Blank.

  3. Refer to the return to verify the entry. Correct any coding or transcription errors.

Section 19
Field Descriptions

  1. Listed below are the fields contained in Section 19 showing the field designator, title, location on the return, and maximum length:




    FIELD



    FIELD TITLE


    LINE
    NO.

    Sch. H
    MAX.
    LENGTH
    1917 Separate Billing and Collections Billing Schedule H, Part V, Section B, Line 17 (prior 2014 – old Line 15) 1
    1918A Reporting to Credit Agency Schedule H, Part V, Section B, Line 18a (prior 2014 – old Line 16a) 1
    1918B Selling an Individuals Debt Schedule H, Part V, Section B, Line 18b (prior 2014 – old Line 16b) 1
    1918C Deferring Denying or Requesting a Payment Schedule H, Part V, Section B, Line 18c (prior 2014 – old Line 16c) 1
    1918D Actions That Require Legal or Judicial Process Schedule H, Part V, Section B, Line 18d (prior 2014 – old Line 16c) 1
    19OLE Action permitted under Body attachments (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, Line 16d) 1
    1918E Other Similar Actions Schedule H, Part V, Section B, Line 18e (prior 2014 – old Line 16e) 1
    1918F None of These Actions Schedule H, Part V, Section B, Line 18f 1
    1919 Reasonable Effort to Determine Eligibility Schedule H, Part V, Section B, Line 19. (prior 2014 – old Line 17) 1
    1919A Reporting to Credit Agency Schedule H, Part V, Section B, Line 19a (prior 2014 – old Line 17a) 1
    1919B Selling an Individuals Debt Schedule H, Part V, Section B, Line 19b (prior 2014 – old Line 17b) 1
    1919C Deferring Denying or Requesting a Payment Schedule H, Part V, Section B, Line 19c 1
    1919D Actions That Require Legal or Judicial Process Schedule H, Part V, Section B, Line 19d (2014 – 2016 – old line 19c.) (prior 2014 – old Line 17c) 1
    19O7D Engaged under Body attachments (prior 2014 - Schedule H, Part V, Section B, Line 17d
    1919E Other Similar Actions Schedule H, Part V, Section B, Line 19d (prior 2014 – old Line 17e) 1
    1920A Provided a Written Notice Schedule H, Part V, Section B, Line 20a (prior 2014 – old Line 18a) 1
    1920B Reasonable Effort to Orally Notify Schedule H, Part V, Section B, Line 20b (prior 2014 – old Line 18b) 1
    1920C Processed Complete and Incomplete FAP Schedule H, Part V, Section B, Line 20c (prior 2014 – old Line 18c) 1
    1920D Made Presumptive Eligibility Determinations Schedule H, Part V, Section B, Line 20d (prior 2014 – old Line 18d) 1
    1920E Other Schedule H, Part V, Section B, Line 20e (prior 2014 – old Line 18e) 1
    1920F None of These Efforts Schedule H, Part V, Section B, Line 20f 1
    1921 Written Policy to Emergency Medical Dare Policy Schedule H, Part V, Section B, Line 21 (prior 2014 – old Line 19) 1
    1921A Did Not Provide Care for Emergency Conditions Schedule H, Part V, Section B, Line 21a (prior 2014 – old Line 19a) 1
    1921B Did Not Have Policy Relating to Emergency Medical Care Schedule H, Part V, Section B, Line 21b (prior 2014 – old Line 19b) 1
    1921C Limited Who Was Eligible Schedule H, Part V, Section B, Line 21c (prior 2014 – old Line 19c) 1
    1921D Other Schedule H, Part V, Section B, Line 21d (prior 2014 – old Line 19d) 1
    1922A Look Back Method Allowed by a Medicare Fee Schedule H, Part V, Section B, Line 22a (prior 2014 – old Line 20a) 1
    1922B Look Back Method Allowed by a Medicare Fee and Private Insurance Schedule H, Part V, Section B, Line 22b (prior 2014 – old Line 20b) 1
    1922C Look Back Method Allowed by Medicaid Either Alone or Combination of Medicare Schedule H, Part V, Section B, Line 22c (prior 2014 – old Line 20c) 1
    1922D Prospective Medicaid or Medicare Method Schedule H, Part V, Section B, Line 22d (prior 2014 – old Line 20d) 1
    1923 Charge Any of Its Patients Schedule H, Part V, Section B, Line 23 (prior 2014 – old Line 21) 1
    1924 Amount Equal to the Gross Charge Schedule H, Part V, Section B, Line 24 (prior 2014 – old Line 22) 1
Section 19
Invalid Conditions/
Correction Procedures
  1. Checkboxes are invalid if not "1" or blank.

  2. All yes/no questions are invalid if not "1" , "2" or Blank.

  3. Refer to the return to verify the entry. Correct any coding or transcription errors.

Section 20
Field Descriptions

  1. Listed below are the fields contained in Section 20 showing the field designator, title, location on the return, and maximum length:




    FIELD



    FIELD TITLE


    LINE
    NO.

    Sch. H
    MAX.
    LENGTH
    20NM1 Name of Facility (part 1) Schedule H, Part V, Section B, Top Portion 20
    20NM2 Name of Facility (continued in part 2) 15
    20ICD Section B Identification Number Code Schedule H, Part V, Section B Edited code 1
    20LNN Line Number reference to section A (valid 2013 and prior ) (prior 2014-Schedule H, Part V, Section B, line number of hospital) 3
    201 Licensed Register State Schedule H, Part V, Section B, Line 1 1
    202 Hospital Acquired in Current Year Schedule H, Part V, Section B, Line 2 2
    203 Hospital Conducted CHNA Schedule H, Part V, Section B, Line 3 (prior 2014 - Old line 1) 1
    203A Definition of Community Served Schedule H, Part V, Section B, Line 3a (prior 2014 - Old line 1a) 1
    203B Demographics of Community Schedule H, Part V, Section B, Line 3b (prior 2014 - Old line 1b) 1
    203C Existing Health Care and Resources Schedule H, Part V, Section B, Line 3c (prior 2014 - Old line 1c) 1
    203D How Data was Obtained Schedule H, Part V, Section B, Line 3d (prior 2014 - Old line 1d) 1
    203E Health Needs of Community Schedule H, Part V, Section B, Line 3e (prior 2014 - Old line 1e) 1
    203F Primary and Chronic Disease Schedule H, Part V, Section B, Line 3f (prior 2014 - Old line 1f) 1
    203G Identifying and Prioritizing Health Needs Schedule H, Part V, Section B, Line 3g (prior 2014 - Old line 1g) 1
    203H Consulting with Persons Representing Schedule H, Part V, Section B, Line 3h (prior 2014 - Old line 1h) 1
    203I Significant Health Needs Identified in the hospital facilities CHNA(s) Schedule H, Part V, Section B, Line 3i (prior 2014 - Old line 1i) 1
    203J Other Schedule H, Part V, Section B, Line 3j (prior 2014 - Old line 1j) 1
    204 Tax Year CHNA Conducted Schedule H, Part V, Section B, Line 4 (prior 2014 - Old line 2) 2
    205 Hospital Facility Take Into Account Input Schedule H, Part V, Section B, Line 5 (prior 2014 - Old line 3) 1
    206A CHNA Conducted with One or More Hospital Facilities Schedule H, Part V, Section B, Line 6a (prior 2014 - Old line 4) 1
    206B CHNA Conducted with One or More Organizations Other than Hospital Facilities Schedule H, Part V, Section B, Line 6b 1
    207 Widely Available to Public Schedule H, Part V, Section B, Line 7 (prior 2014 - Old line 5) 1
    207A Hospital Website Schedule H, Part V, Section B, Line 7a (prior 2014 - Old line 5a) 1
    207B Other Website Schedule H, Part V, Section B, Line 7b 1
    207C Available Upon Request Schedule H, Part V, Section B, Line 7c (prior 2014 - Old line 5c) 1
    207D Other Schedule H, Part V, Section B, Line 7d (prior 2014 - Old line 5d) 1
    20O6A Facility addressed needs adopt (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6a) 1
    20O6B Facility addressed needs execution (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6b) 1
    20O6C Facility addressed needs development (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6c) 1
    20O6D Facility addressed needs part in execution (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6d) 1
    20O6E Facility addressed needs inclusion (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6e) 1
    20O6F Facility addressed needs budget (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6f) 1
    20O6G Facility addressed needs prioritization (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6g) 1
    20O6H Facility addressed needs services (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6h) 1
    20O6I Facility addressed needs other (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6i) 1
    20OL7 Addressed needs identified (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 7) 1
Section 20
Invalid Conditions/
Correction Procedures
  1. Checkboxes are invalid if not "1" or blank.

  2. All yes/no questions are invalid if not "1" , "2" or Blank.

  3. Refer to the return to verify the entry. Correct any coding or transcription errors.

Section 21
Field Descriptions

  1. Listed below are the fields contained in Section 21 showing the field designator, title, location on the return, and maximum length:




    FIELD



    FIELD TITLE


    LINE
    NO.

    Sch. H
    MAX.
    LENGTH
    218 Adopt Implementation Strategy Schedule H, Part V, Section B, Line 8 1
    219 Tax Year Strategy Implemented Schedule H, Part V, Section B, Line 9 1
    2110 Strategy Posted on Website Schedule H, Part V, Section B, Line 10 1
    2110A URL Present Indicator Schedule H, Part V, Section B, Line 10a 1
    2110B Strategy Attached Schedule H, Part V, Section B, Line 10b 1
    2112A Excise Tax Under 4959 Schedule H, Part V, Section B, Line 12a (prior 2014 - Old line 8a) 1
    2112B Did Organization File 4720 Schedule H, Part V, Section B, Line 12b (prior 2014 - Old line 8b) 1
    2112C 4959 Tax Reported Schedule H, Part V, Section B, Line 12c (prior 2014 - Old line 8c) 15
    2113 Explained Eligibility Criteria Schedule H, Part V, Section B, Line 13 (prior 2014 - Old line 9) 1
    2113A Uses Federal Poverty Guidelines Free Care Schedule H, Part V, Section B, Line 13a (prior 2014 - Old line 10) 1
    21A1P Free Care Percentage Schedule H, Part V, Section B, Line 13a, 1st percentage. (prior 2014 - Old line 10%) 3
    21O11 Use FPG Discounted care (valid 2013 and prior ) (prior 2014 - Schedule H, Part V, Section B, old Line 11) 1
    21A2P Discounted Care Percentage Schedule H, Part V, Section B, Line 13a, 2nd percentage. (prior 2014 - Old line 11%) 3
    21O12 Explained basis for calculating charged (valid 2013 and prior ) (prior 2014 - Schedule H, Part V, Section B, old Line 11) 1
    2113B Income Level Other than FPG Schedule H, Part V, Section B, Line 13b (prior 2014 - Old line 12a) 1
    2113C Asset Level Schedule H, Part V, Section B, Line 13c (prior 2014 - Old line 12b) 1
    2113D Medical Indigency Schedule H, Part V, Section B, Line 13d (prior 2014 - Old line 12c) 1
    2113E Insurance Status Schedule H, Part V, Section B, Line 13e (prior 2014 - Old line 12d) 1
    2113F Underinsurance Status Schedule H, Part V, Section B, Line 13f (prior 2014 - Old line 12e) 1
    21OLF Basis calculating Medicaid/Medicare (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 12f) 1
    21OLG Basis calculating State Regulation (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 12g) 1
    2113G Residency Schedule H, Part V, Section B, Line 13g 1
    2113H Other Schedule H, Part V, Section B, Line 13h (prior 2014 - Old line 12i) 1
    2114 Calculating Amounts Charged to Patient Schedule H, Part V, Section B, Line 14 1
    2115 Explained the Method for Applying Financial Assistance Schedule H, Part V, Section B, Line 15 (prior 2014 - Old line 13) 1
    2115A Information Hospital Required on Application Schedule H, Part V, Section B, Line 15a 1
    2115B Supporting Information Required on Application Schedule H, Part V, Section B, Line 15b 1
    2115C Contact Information Schedule H, Part V, Section B, Line 15c 1
    2115D Contact Information Sources of Financial Assistance Schedule H, Part V, Section B, Line 15d 1
    2115E Other Schedule H, Part V, Section B, Line 15e 1
    2116 Was Widely Publicized Schedule H, Part V, Section B, Line 16. (prior 2014 - Old line 14) 1
    2116A FAP Available on Website Schedule H, Part V, Section B, Line 16a 1
    2116B FAP Application on Website Schedule H, Part V, Section B, Line 16b 1
    2116C Plain Language Summary Schedule H, Part V, Section B, Line 16c 1
    2116D FAP Available on Request Schedule H, Part V, Section B, Line 16d 1
    2116E FAP Application Form Upon Request Schedule H, Part V, Section B, Line 16e 1
    2116F Plain Language FAP Available Schedule H, Part V, Section B, Line 16f 1
    2116G Individuals Notified about FAP Schedule H, Part V, Section B, Line 16g 1
    2116H FAP Customers Notified Schedule H, Part V, Section B, Line 16h 1
    2116I FAP Translated into Primary Language of LEP Schedule H, Part V, Section B, Line 16i 1
    2116J Other Schedule H, Part V, Section B, Line 16j 1
    21O4A Policy posted on website (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14a) 1
    21O4B Policy attached billing (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14b) 1
    21O4C Policy posted in room (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14c) 1
    21O4D Policy posted in admin offices (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14d) 1
    21O4E Policy provided (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14e) 1
    21O4F Policy upon request (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14f) 1
    21O4G Policy other method (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14g) 1
Section 21
Invalid Conditions/
Correction Procedures
  1. Checkboxes are invalid if not "1" or blank.

  2. All yes/no questions are invalid if not "1" , "2" or Blank.

  3. Refer to the return to verify the entry. Correct any coding or transcription errors.

Section 22
Field Descriptions

  1. Listed below are the fields contained in Section 22 showing the field designator, title, location on the return, and maximum length:




    FIELD



    FIELD TITLE


    LINE
    NO.

    Sch. H
    MAX.
    LENGTH
    2217 Separate Billing and Collections Billing Schedule H, Part V, Section B, Line 17 (prior 2014 – old Line 15) 1
    2218A Reporting to Credit Agency Schedule H, Part V, Section B, Line 18a (prior 2014 – old Line 16a) 1
    2218B Selling an Individuals Debt Schedule H, Part V, Section B, Line 18b (prior 2014 – old Line 16b) 1
    2218C Deferring Denying or Requesting a Payment Schedule H, Part V, Section B, Line 18c (prior 2014 – old Line 16c) 1
    2218D Actions That Require Legal or Judicial Process Schedule H, Part V, Section B, Line 18d (prior 2014 – old Line 16c) 1
    22OLE Action permitted under Body attachments (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, Line 16d) 1
    2218E Other Similar Actions Schedule H, Part V, Section B, Line 18e (prior 2014 – old Line 16e) 1
    2218F None of These Actions Schedule H, Part V, Section B, Line 18f 1
    2219 Reasonable Effort to Determine Eligibility Schedule H, Part V, Section B, Line 19. (prior 2014 – old Line 17) 1
    2219A Reporting to Credit Agency Schedule H, Part V, Section B, Line 19a (prior 2014 – old Line 17a) 1
    2219B Selling an Individuals Debt Schedule H, Part V, Section B, Line 19b (prior 2014 – old Line 17b) 1
    2219C Deferring Denying or Requesting a Payment Schedule H, Part V, Section B, Line 19c 1
    2219D Actions That Require Legal or Judicial Process Schedule H, Part V, Section B, Line 19d (2014 – 2016 – old line 19c.) (prior 2014 – old Line 17c) 1
    22O7D Engaged under Body attachments (prior 2014 - Schedule H, Part V, Section B, Line 17d
    2219E Other Similar Actions Schedule H, Part V, Section B, Line 19d (prior 2014 – old Line 17e) 1
    2220A Provided a Written Notice Schedule H, Part V, Section B, Line 20a (prior 2014 – old Line 18a) 1
    2220B Reasonable Effort to Orally Notify Schedule H, Part V, Section B, Line 20b (prior 2014 – old Line 18b) 1
    2220C Processed Complete and Incomplete FAP Schedule H, Part V, Section B, Line 20c (prior 2014 – old Line 18c) 1
    2220D Made Presumptive Eligibility Determinations Schedule H, Part V, Section B, Line 20d (prior 2014 – old Line 18d) 1
    2220E Other Schedule H, Part V, Section B, Line 20e (prior 2014 – old Line 18e) 1
    2220F None of These Efforts Schedule H, Part V, Section B, Line 20f 1
    2221 Written Policy to Emergency Medical Dare Policy Schedule H, Part V, Section B, Line 21 (prior 2014 – old Line 19) 1
    2221A Did Not Provide Care for Emergency Conditions Schedule H, Part V, Section B, Line 21a (prior 2014 – old Line 19a) 1
    2221B Did Not Have Policy Relating to Emergency Medical Care Schedule H, Part V, Section B, Line 21b (prior 2014 – old Line 19b) 1
    2221C Limited Who Was Eligible Schedule H, Part V, Section B, Line 21c (prior 2014 – old Line 19c) 1
    2221D Other Schedule H, Part V, Section B, Line 21d (prior 2014 – old Line 19d) 1
    2222A Look Back Method Allowed by a Medicare Fee Schedule H, Part V, Section B, Line 22a (prior 2014 – old Line 20a) 1
    2222B Look Back Method Allowed by a Medicare Fee and Private Insurance Schedule H, Part V, Section B, Line 22b (prior 2014 – old Line 20b) 1
    2222C Look Back Method Allowed by Medicaid Either Alone or Combination of Medicare Schedule H, Part V, Section B, Line 22c (prior 2014 – old Line 20c) 1
    2222D Prospective Medicaid or Medicare Method Schedule H, Part V, Section B, Line 22d (prior 2014 – old Line 20d) 1
    2223 Charge Any of Its Patients Schedule H, Part V, Section B, Line 23 (prior 2014 – old Line 21) 1
    2224 Amount Equal to the Gross Charge Schedule H, Part V, Section B, Line 24 (prior 2014 – old Line 22) 1
Section 22
Invalid Conditions/
Correction Procedures
  1. Checkboxes are invalid if not "1" or blank.

  2. All yes/no questions are invalid if not "1" , "2" or Blank.

  3. Refer to the return to verify the entry. Correct any coding or transcription errors.

Section 23
Field Descriptions

  1. Listed below are the fields contained in Section 23 showing the field designator, title, location on the return, and maximum length:




    FIELD



    FIELD TITLE


    LINE
    NO.

    Sch. H
    MAX.
    LENGTH
    23NM1 Name of Facility (part 1) Schedule H, Part V, Section B, Top Portion 20
    23NM2 Name of Facility (continued in part 2) 15
    23ICD Section B Identification Number Code Schedule H, Part V, Section B Edited code 1
    23LNN Line Number reference to section A (valid 2013 and prior ) (prior 2014-Schedule H, Part V, Section B, line number of hospital) 3
    231 Licensed Register State Schedule H, Part V, Section B, Line 1 1
    232 Hospital Acquired in Current Year Schedule H, Part V, Section B, Line 2 2
    233 Hospital Conducted CHNA Schedule H, Part V, Section B, Line 3 (prior 2014 - Old line 1) 1
    233A Definition of Community Served Schedule H, Part V, Section B, Line 3a (prior 2014 - Old line 1a) 1
    233B Demographics of Community Schedule H, Part V, Section B, Line 3b (prior 2014 - Old line 1b) 1
    233C Existing Health Care and Resources Schedule H, Part V, Section B, Line 3c (prior 2014 - Old line 1c) 1
    233D How Data was Obtained Schedule H, Part V, Section B, Line 3d (prior 2014 - Old line 1d) 1
    233E Health Needs of Community Schedule H, Part V, Section B, Line 3e (prior 2014 - Old line 1e) 1
    233F Primary and Chronic Disease Schedule H, Part V, Section B, Line 3f (prior 2014 - Old line 1f) 1
    233G Identifying and Prioritizing Health Needs Schedule H, Part V, Section B, Line 3g (prior 2014 - Old line 1g) 1
    233H Consulting with Persons Representing Schedule H, Part V, Section B, Line 3h (prior 2014 - Old line 1h) 1
    233I Significant Health Needs Identified in the hospital facilities CHNA(s) Schedule H, Part V, Section B, Line 3i (prior 2014 - Old line 1i) 1
    233J Other Schedule H, Part V, Section B, Line 3j (prior 2014 - Old line 1j) 1
    234 Tax Year CHNA Conducted Schedule H, Part V, Section B, Line 4 (prior 2014 - Old line 2) 2
    235 Hospital Facility Take Into Account Input Schedule H, Part V, Section B, Line 5 (prior 2014 - Old line 3) 1
    236A CHNA Conducted with One or More Hospital Facilities Schedule H, Part V, Section B, Line 6a (prior 2014 - Old line 4) 1
    236B CHNA Conducted with One or More Organizations Other than Hospital Facilities Schedule H, Part V, Section B, Line 6b 1
    237 Widely Available to Public Schedule H, Part V, Section B, Line 7 (prior 2014 - Old line 5) 1
    237A Hospital Website Schedule H, Part V, Section B, Line 7a (prior 2014 - Old line 5a) 1
    237B Other Website Schedule H, Part V, Section B, Line 7b 1
    237C Available Upon Request Schedule H, Part V, Section B, Line 7c (prior 2014 - Old line 5c) 1
    237D Other Schedule H, Part V, Section B, Line 7d (prior 2014 - Old line 5d) 1
    23O6A Facility addressed needs adopt (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6a) 1
    23O6B Facility addressed needs execution (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6b) 1
    23O6C Facility addressed needs development (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6c) 1
    23O6D Facility addressed needs part in execution (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6d) 1
    23O6E Facility addressed needs inclusion (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6e) 1
    23O6F Facility addressed needs budget (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6f) 1
    23O6G Facility addressed needs prioritization (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6g) 1
    23O6H Facility addressed needs services (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6h) 1
    23O6I Facility addressed needs other (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6i) 1
    23OL7 Addressed needs identified (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 7) 1
Section 23
Invalid Conditions/
Correction Procedures
  1. Checkboxes are invalid if not "1" or blank.

  2. All yes/no questions are invalid if not "1" , "2" or Blank.

  3. Refer to the return to verify the entry. Correct any coding or transcription errors.

Section 24
Field Descriptions

  1. Listed below are the fields contained in Section 24 showing the field designator, title, location on the return, and maximum length:




    FIELD



    FIELD TITLE


    LINE
    NO.

    Sch. H
    MAX.
    LENGTH
    248 Adopt Implementation Strategy Schedule H, Part V, Section B, Line 8 1
    249 Tax Year Strategy Implemented Schedule H, Part V, Section B, Line 9 1
    2410 Strategy Posted on Website Schedule H, Part V, Section B, Line 10 1
    2410A URL Present Indicator Schedule H, Part V, Section B, Line 10a 1
    2410B Strategy Attached Schedule H, Part V, Section B, Line 10b 1
    2412A Excise Tax Under 4959 Schedule H, Part V, Section B, Line 12a (prior 2014 - Old line 8a) 1
    2412B Did Organization File 4720 Schedule H, Part V, Section B, Line 12b (prior 2014 - Old line 8b) 1
    2412C 4959 Tax Reported Schedule H, Part V, Section B, Line 12c (prior 2014 - Old line 8c) 15
    2413 Explained Eligibility Criteria Schedule H, Part V, Section B, Line 13 (prior 2014 - Old line 9) 1
    2413A Uses Federal Poverty Guidelines Free Care Schedule H, Part V, Section B, Line 13a (prior 2014 - Old line 10) 1
    24A1P Free Care Percentage Schedule H, Part V, Section B, Line 13a, 1st percentage. (prior 2014 - Old line 10%) 3
    24O11 Use FPG Discounted care (valid 2013 and prior ) (prior 2014 - Schedule H, Part V, Section B, old Line 11) 1
    24A2P Discounted Care Percentage Schedule H, Part V, Section B, Line 13a, 2nd percentage. (prior 2014 - Old line 11%) 3
    24O12 Explained basis for calculating charged (valid 2013 and prior ) (prior 2014 - Schedule H, Part V, Section B, old Line 11) 1
    2413B Income Level Other than FPG Schedule H, Part V, Section B, Line 13b (prior 2014 - Old line 12a) 1
    2413C Asset Level Schedule H, Part V, Section B, Line 13c (prior 2014 - Old line 12b) 1
    2413D Medical Indigency Schedule H, Part V, Section B, Line 13d (prior 2014 - Old line 12c) 1
    2413E Insurance Status Schedule H, Part V, Section B, Line 13e (prior 2014 - Old line 12d) 1
    2413F Underinsurance Status Schedule H, Part V, Section B, Line 13f (prior 2014 - Old line 12e) 1
    24OLF Basis calculating Medicaid/Medicare (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 12f) 1
    24OLG Basis calculating State Regulation (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 12g) 1
    2413G Residency Schedule H, Part V, Section B, Line 13g 1
    2413H Other Schedule H, Part V, Section B, Line 13h (prior 2014 - Old line 12i) 1
    2414 Calculating Amounts Charged to Patient Schedule H, Part V, Section B, Line 14 1
    2415 Explained the Method for Applying Financial Assistance Schedule H, Part V, Section B, Line 15 (prior 2014 - Old line 13) 1
    2415A Information Hospital Required on Application Schedule H, Part V, Section B, Line 15a 1
    2415B Supporting Information Required on Application Schedule H, Part V, Section B, Line 15b 1
    2415C Contact Information Schedule H, Part V, Section B, Line 15c 1
    2415D Contact Information Sources of Financial Assistance Schedule H, Part V, Section B, Line 15d 1
    2415E Other Schedule H, Part V, Section B, Line 15e 1
    2416 Was Widely Publicized Schedule H, Part V, Section B, Line 16. (prior 2014 - Old line 14) 1
    2416A FAP Available on Website Schedule H, Part V, Section B, Line 16a 1
    2416B FAP Application on Website Schedule H, Part V, Section B, Line 16b 1
    2416C Plain Language Summary Schedule H, Part V, Section B, Line 16c 1
    2416D FAP Available on Request Schedule H, Part V, Section B, Line 16d 1
    2416E FAP Application Form Upon Request Schedule H, Part V, Section B, Line 16e 1
    2416F Plain Language FAP Available Schedule H, Part V, Section B, Line 16f 1
    2416G Individuals Notified about FAP Schedule H, Part V, Section B, Line 16g 1
    2416H FAP Customers Notified Schedule H, Part V, Section B, Line 16h 1
    2416I FAP Translated into Primary Language of LEP Schedule H, Part V, Section B, Line 161 1
    2416J Other Schedule H, Part V, Section B, Line 16j 1
    24O4A Policy posted on website (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14a) 1
    24O4B Policy attached billing (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14b) 1
    24O4C Policy posted in room (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14c) 1
    24O4D Policy posted in admin offices (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14d) 1
    22O4E Policy provided (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14e) 1
    24O4F Policy upon request (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14f) 1
    24O4G Policy other method (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14g) 1
Section 24
Invalid Conditions/
Correction Procedures
  1. Checkboxes are invalid if not "1" or blank.

  2. All yes/no questions are invalid if not "1" , "2" or Blank.

  3. Refer to the return to verify the entry. Correct any coding or transcription errors.

Section 25
Field Descriptions

  1. Listed below are the fields contained in Section 25 showing the field designator, title, location on the return, and maximum length:




    FIELD



    FIELD TITLE


    LINE
    NO.

    Sch. H
    MAX.
    LENGTH
    2517 Separate Billing and Collections Billing Schedule H, Part V, Section B, Line 17 (prior 2014 – old Line 15) 1
    2518A Reporting to Credit Agency Schedule H, Part V, Section B, Line 18a (prior 2014 – old Line 16a) 1
    2518B Selling an Individuals Debt Schedule H, Part V, Section B, Line 18b (prior 2014 – old Line 16b) 1
    2518C Deferring Denying or Requesting a Payment Schedule H, Part V, Section B, Line 18c (prior 2014 – old Line 16c) 1
    2518D Actions That Require Legal or Judicial Process Schedule H, Part V, Section B, Line 18d (prior 2014 – old Line 16c) 1
    25OLE Action permitted under Body attachments (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, Line 16d) 1
    2518E Other Similar Actions Schedule H, Part V, Section B, Line 18e (prior 2014 – old Line 16e) 1
    2518F None of These Actions Schedule H, Part V, Section B, Line 18f 1
    2519 Reasonable Effort to Determine Eligibility Schedule H, Part V, Section B, Line 19. (prior 2014 – old Line 17) 1
    2519A Reporting to Credit Agency Schedule H, Part V, Section B, Line 19a (prior 2014 – old Line 17a) 1
    2519B Selling an Individuals Debt Schedule H, Part V, Section B, Line 19b (prior 2014 – old Line 17b) 1
    2519C Deferring Denying or Requesting a Payment Schedule H, Part V, Section B, Line 19c 1
    2519D Actions That Require Legal or Judicial Process Schedule H, Part V, Section B, Line 19d (2014 – 2016 – old line 19c.) (prior 2014 – old Line 17c) 1
    25O7D Engaged under Body attachments (prior 2014 - Schedule H, Part V, Section B, Line 17d
    2519E Other Similar Actions Schedule H, Part V, Section B, Line 19d (prior 2014 – old Line 17e) 1
    2520A Provided a Written Notice Schedule H, Part V, Section B, Line 20a (prior 2014 – old Line 18a) 1
    2520B Reasonable Effort to Orally Notify Schedule H, Part V, Section B, Line 20b (prior 2014 – old Line 18b) 1
    2520C Processed Complete and Incomplete FAP Schedule H, Part V, Section B, Line 20c (prior 2014 – old Line 18c) 1
    2520D Made Presumptive Eligibility Determinations Schedule H, Part V, Section B, Line 20d (prior 2014 – old Line 18d) 1
    2520E Other Schedule H, Part V, Section B, Line 20e (prior 2014 – old Line 18e) 1
    2520F None of These Efforts Schedule H, Part V, Section B, Line 20f 1
    2521 Written Policy to Emergency Medical Dare Policy Schedule H, Part V, Section B, Line 21 (prior 2014 – old Line 19) 1
    2521A Did Not Provide Care for Emergency Conditions Schedule H, Part V, Section B, Line 21a (prior 2014 – old Line 19a) 1
    2521B Did Not Have Policy Relating to Emergency Medical Care Schedule H, Part V, Section B, Line 21b (prior 2014 – old Line 19b) 1
    2521C Limited Who Was Eligible Schedule H, Part V, Section B, Line 21c (prior 2014 – old Line 19c) 1
    2521D Other Schedule H, Part V, Section B, Line 21d (prior 2014 – old Line 19d) 1
    2522A Look Back Method Allowed by a Medicare Fee Schedule H, Part V, Section B, Line 22a (prior 2014 – old Line 20a) 1
    2522B Look Back Method Allowed by a Medicare Fee and Private Insurance Schedule H, Part V, Section B, Line 22b (prior 2014 – old Line 20b) 1
    2522C Look Back Method Allowed by Medicaid Either Alone or Combination of Medicare Schedule H, Part V, Section B, Line 22c (prior 2014 – old Line 20c) 1
    2522D Prospective Medicaid or Medicare Method Schedule H, Part V, Section B, Line 22d (prior 2014 – old Line 20d) 1
    2523 Charge Any of Its Patients Schedule H, Part V, Section B, Line 23 (prior 2014 – old Line 21) 1
    2524 Amount Equal to the Gross Charge Schedule H, Part V, Section B, Line 24 (prior 2014 – old Line 22) 1
Section 25
Invalid Conditions/
Correction Procedures
  1. Checkboxes are invalid if not "1" or blank.

  2. All yes/no questions should be answered. Questions are invalid if not "1" or "2" .

  3. Refer to the return to verify the entry. Correct any coding or transcription errors.

Section 26
Field Descriptions

  1. Listed below are the fields contained in Section 26 showing the field designator, title, location on the return, and maximum length:




    FIELD



    FIELD TITLE


    LINE
    NO.

    Sch. H
    MAX.
    LENGTH
    26NM1 Name of Facility (part 1) Schedule H, Part V, Section B, Top Portion 20
    26NM2 Name of Facility (continued in part 2) 15
    26ICD Section B Identification Number Code Schedule H, Part V, Section B Edited code 1
    26LNN Line Number reference to section A (valid 2013 and prior ) (prior 2014-Schedule H, Part V, Section B, line number of hospital) 3
    261 Licensed Register State Schedule H, Part V, Section B, Line 1 1
    262 Hospital Acquired in Current Year Schedule H, Part V, Section B, Line 2 2
    263 Hospital Conducted CHNA Schedule H, Part V, Section B, Line 3 (prior 2014 - Old line 1) 1
    263A Definition of Community Served Schedule H, Part V, Section B, Line 3a (prior 2014 - Old line 1a) 1
    263B Demographics of Community Schedule H, Part V, Section B, Line 3b (prior 2014 - Old line 1b) 1
    263C Existing Health Care and Resources Schedule H, Part V, Section B, Line 3c (prior 2014 - Old line 1c) 1
    263D How Data was Obtained Schedule H, Part V, Section B, Line 3d (prior 2014 - Old line 1d) 1
    263E Health Needs of Community Schedule H, Part V, Section B, Line 3e (prior 2014 - Old line 1e) 1
    263F Primary and Chronic Disease Schedule H, Part V, Section B, Line 3f (prior 2014 - Old line 1f) 1
    263G Identifying and Prioritizing Health Needs Schedule H, Part V, Section B, Line 3g (prior 2014 - Old line 1g) 1
    263H Consulting with Persons Representing Schedule H, Part V, Section B, Line 3h (prior 2014 - Old line 1h) 1
    263I Significant Health Needs Identified in the hospital facilities CHNA(s) Schedule H, Part V, Section B, Line 3i (prior 2014 - Old line 1i) 1
    263J Other Schedule H, Part V, Section B, Line 3j (prior 2014 - Old line 1j) 1
    264 Tax Year CHNA Conducted Schedule H, Part V, Section B, Line 4 (prior 2014 - Old line 2) 2
    265 Hospital Facility Take Into Account Input Schedule H, Part V, Section B, Line 5 (prior 2014 - Old line 3) 1
    266A CHNA Conducted with One or More Hospital Facilities Schedule H, Part V, Section B, Line 6a (prior 2014 - Old line 4) 1
    266B CHNA Conducted with One or More Organizations Other than Hospital Facilities Schedule H, Part V, Section B, Line 6b 1
    267 Widely Available to Public Schedule H, Part V, Section B, Line 7 (prior 2014 - Old line 5) 1
    267A Hospital Website Schedule H, Part V, Section B, Line 7a (prior 2014 - Old line 5a) 1
    267B Other Website Schedule H, Part V, Section B, Line 7b 1
    267C Available Upon Request Schedule H, Part V, Section B, Line 7c (prior 2014 - Old line 5c) 1
    267D Other Schedule H, Part V, Section B, Line 7d (prior 2014 - Old line 5d) 1
    26O6A Facility addressed needs adopt (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6a) 1
    26O6B Facility addressed needs execution (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6b) 1
    26O6C Facility addressed needs development (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6c) 1
    26O6D Facility addressed needs part in execution (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6d) 1
    26O6E Facility addressed needs inclusion (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6e) 1
    26O6F Facility addressed needs budget (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6f) 1
    26O6G Facility addressed needs prioritization (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6g) 1
    26O6H Facility addressed needs services (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6h) 1
    26O6I Facility addressed needs other (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 6i) 1
    26OL7 Addressed needs identified (valid 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old line 7) 1

Section 26
Invalid Conditions/
Correction Procedures

  1. Checkboxes are invalid if not "1" or blank.

  2. All yes/no questions should be answered. Questions are invalid if not "1" or "2" .

  3. Refer to the return to verify the entry. Correct any coding or transcription errors.

Section 27
Field Descriptions

  1. Listed below are the fields contained in Section 27 showing the field designator, title, location on the return, and maximum length:




    FIELD



    FIELD TITLE


    LINE
    NO.

    Sch. H
    MAX.
    LENGTH
    278 Adopt Implementation Strategy Schedule H, Part V, Section B, Line 8 1
    279 Tax Year Strategy Implemented Schedule H, Part V, Section B, Line 9 1
    2710 Strategy Posted on Website Schedule H, Part V, Section B, Line 10 1
    2710A URL Present Indicator Schedule H, Part V, Section B, Line 10a 1
    2710B Strategy Attached Schedule H, Part V, Section B, Line 10b 1
    2712A Excise Tax Under 4959 Schedule H, Part V, Section B, Line 12a (prior 2014 - Old line 8a) 1
    2712B Did Organization File 4720 Schedule H, Part V, Section B, Line 12b (prior 2014 - Old line 8b) 1
    2712C 4959 Tax Reported Schedule H, Part V, Section B, Line 12c (prior 2014 - Old line 8c) 15
    2713 Explained Eligibility Criteria Schedule H, Part V, Section B, Line 13 (prior 2014 - Old line 9) 1
    2713A Uses Federal Poverty Guidelines Free Care Schedule H, Part V, Section B, Line 13a (prior 2014 - Old line 10) 1
    27A1P Free Care Percentage Schedule H, Part V, Section B, Line 13a, 1st percentage. (prior 2014 - Old line 10%) 3
    27O11 Use FPG Discounted care (valid 2013 and prior ) (prior 2014 - Schedule H, Part V, Section B, old Line 11) 1
    27A2P Discounted Care Percentage Schedule H, Part V, Section B, Line 13a, 2nd percentage. (prior 2014 - Old line 11%) 3
    27O12 Explained basis for calculating charged (valid 2013 and prior ) (prior 2014 - Schedule H, Part V, Section B, old Line 11) 1
    2713B Income Level Other than FPG Schedule H, Part V, Section B, Line 13b (prior 2014 - Old line 12a) 1
    2713C Asset Level Schedule H, Part V, Section B, Line 13c (prior 2014 - Old line 12b) 1
    2713D Medical Indigency Schedule H, Part V, Section B, Line 13d (prior 2014 - Old line 12c) 1
    2713E Insurance Status Schedule H, Part V, Section B, Line 13e (prior 2014 - Old line 12d) 1
    2713F Underinsurance Status Schedule H, Part V, Section B, Line 13f (prior 2014 - Old line 12e) 1
    27OLF Basis calculating Medicaid/Medicare (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 12f) 1
    27OLG Basis calculating State Regulation (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 12g) 1
    2713G Residency Schedule H, Part V, Section B, Line 13g 1
    2713H Other Schedule H, Part V, Section B, Line 13h (prior 2014 - Old line 12i) 1
    2714 Calculating Amounts Charged to Patient Schedule H, Part V, Section B, Line 14 1
    2715 Explained the Method for Applying Financial Assistance Schedule H, Part V, Section B, Line 15 (prior 2014 - Old line 13) 1
    2715A Information Hospital Required on Application Schedule H, Part V, Section B, Line 15a 1
    2715B Supporting Information Required on Application Schedule H, Part V, Section B, Line 15b 1
    2715C Contact Information Schedule H, Part V, Section B, Line 15c 1
    2715D Contact Information Sources of Financial Assistance Schedule H, Part V, Section B, Line 15d 1
    2715E Other Schedule H, Part V, Section B, Line 15e 1
    2716 Was Widely Publicized Schedule H, Part V, Section B, Line 16. (prior 2014 - Old line 14) 1
    2716A FAP Available on Website Schedule H, Part V, Section B, Line 16a 1
    2716B FAP Application on Website Schedule H, Part V, Section B, Line 16b 1
    2716C Plain Language Summary Schedule H, Part V, Section B, Line 16c 1
    2716D FAP Available on Request Schedule H, Part V, Section B, Line 16d 1
    2716E FAP Application Form Upon Request Schedule H, Part V, Section B, Line 16e 1
    2716F Plain Language FAP Available Schedule H, Part V, Section B, Line 16f 1
    2716G Individuals Notified about FAP Schedule H, Part V, Section B, Line 16g 1
    2716H FAP Customers Notified Schedule H, Part V, Section B, Line 16h 1
    2716I FAP Translated into Primary Language of LEP Schedule H, Part V, Section B, Line 16i 1
    2716J Other Schedule H, Part V, Section B, Line 16j 1
    27O4A Policy posted on website (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14a) 1
    27O4B Policy attached billing (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14b) 1
    27O4C Policy posted in room (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14c) 1
    27O4D Policy posted in admin offices (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14d) 1
    27O4E Policy provided (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14e) 1
    27O4F Policy upon request (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14f) 1
    27O4G Policy other method (valid for 2013 and prior) (prior 2014 - Schedule H, Part V, Section B, old Line 14g) 1
Section 27
Invalid Conditions/
Correction Procedures
  1. Checkboxes are invalid if not "1" or blank.

  2. All yes/no questions should be answered. Questions are invalid if not "1" or "2" .

  3. Refer to the return to verify the entry. Correct any coding or transcription errors.

Section 28
Field Descriptions

  1. Listed below are the fields contained in Section 28 showing the field designator, title, location on the return, and maximum length:




    FIELD



    FIELD TITLE


    LINE
    NO.

    Sch. H
    MAX.
    LENGTH
    2817 Separate Billing and Collections Billing Schedule H, Part V, Section B, Line 17 (prior 2014 – old Line 15) 1
    2818A Reporting to Credit Agency Schedule H, Part V, Section B, Line 18a (prior 2014 – old Line 16a) 1
    2818B Selling an Individuals Debt Schedule H, Part V, Section B, Line 18b (prior 2014 – old Line 16b) 1
    2818C Deferring Denying or Requesting a Payment Schedule H, Part V, Section B, Line 18c (prior 2014 – old Line 16c) 1
    2818D Actions That Require Legal or Judicial Process Schedule H, Part V, Section B, Line 18d (prior 2014 – old Line 16c) 1