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Field Seq.Position FromPosition ToDescriptionField SizeField TypeRequiredNotesCCG Comment
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113Upload Form ID3N(3,0)YValue = 620 for every record
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249Serial Number6N(6,0)YSequential Record Number (1, 2, 3, etc.)
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31017Process Date8N(8,0)NMMDDYYYY - Date the Sponsor processed the data. This is for informational purposes only for the sponsor.
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41823Blank6C(6)NLeave Blank
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52487Sponsor Name64C(64)YName of Sponsor
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68892Agreement Number5C(5)YSponsor agreement number
Do not include dashes; zero fill from left e.g. 01234
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79394Claim Month2N(2,0)YEnter the month the claim is being submitted for:
Calendar month number (01, 02, …. 11, 12)
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89598Claim Year4N(4,0)YEnter the year the claim is being submitted for:
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999130Provider First Name32C(32)YFirst Name of Provider
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10131162Provider Last Name32C(32)YLast Name of Provider
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11163178License Number16C(16)NCurrent License Number of the provider
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12179190Provider ID12N(12)YUnique CIPS system generated provider ID. This is the value displayed in the header above the provider’s name.
Unique ID (for a given sponsor) that will be used as the provider record locator when importing the data. (Note: if the value cannot be found, the record will not be uploaded.)
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13191206Alternate Provider ID Not In Use for this layout16C(16)NLeave Blank
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14207213Children Enrolled Tier I7N(7,0)NIf not claiming Tier I, leave blank
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15214220Children Enrolled Tier II High7N(7,0)NIf not claiming Tier II High, leave blank
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16221227Children Enrolled Tier II Low7N(7,0)NIf not claiming Tier II Low, leave blank
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17228234Number of Homes Participating Tier II Mix7N(7,0)NIf not claiming Tier II Mix, leave blank
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18235241Number of Days Meals Served Tier I7N(7,0)NIf not claiming Tier I, leave blank
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19242248Number of Days Meals Served Tier II High7N(7,0)NIf not claiming Tier II High, leave blank
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20249255Number of Days Meals Served Tier II Low7N(7,0)NIf not claiming Tier II Low, leave blank
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21256262Number of Days Meals Served Tier II Mix7N(7,0)NIf not claiming Tier II Mix, leave blank
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22263269Total Attendance Tier I7N(7,0)NIf not claiming Tier I, leave blank
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23270276Total Attendance Tier II High7N(7,0)NIf not claiming Tier II High, leave blank
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24277283Total Attendance Tier II Low7N(7,0)NIf not claiming Tier II Low, leave blank
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25284290Total Attendance Tier II Mix7N(7,0)NIf not claiming Tier II Mix, leave blank
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26291297Breakfast Tier I Meals Served7N(7,0)NIf not claiming Tier I, leave blank
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27298304Breakfast Tier II High Meals Served7N(7,0)NIf not claiming Tier II High, leave blank
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283053117N(7,0)NIf not claiming Tier II Low, leave blank
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29312318AM Snack Tier I Meals Served7N(7,0)NIf not claiming Tier I, leave blank
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30319325AM Snack Tier II High Meals Served7N(7,0)NIf not claiming Tier II High, leave blank
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31326332AM Snack Tier II Low Meals Served7N(7,0)NIf not claiming Tier II Low, leave blank
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32333339Lunch Tier I Meals Served7N(7,0)NIf not claiming Tier I, leave blank
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33340346Lunch Tier II High Meals Served7N(7,0)NIf not claiming Tier II High, leave blank
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34347353Lunch Tier II Low Meals Served7N(7,0)NIf not claiming Tier II Low, leave blank
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35354360PM Snack Tier I Meals Served7N(7,0)NIf not claiming Tier I, leave blank
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36361367PM Snack Tier II High Meals Served7N(7,0)NIf not claiming Tier II High, leave blank
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37368374PM Snack Tier II Low Meals Served7N(7,0)NIf not claiming Tier II Low, leave blank
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38375381Supper Tier I Meals Served7N(7,0)NIf not claiming Tier I, leave blank
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39382388Supper Tier II High Meals Served7N(7,0)NIf not claiming Tier II High, leave blank
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40389395Supper Tier II Low Meals Served7N(7,0)NIf not claiming Tier II Low, leave blank
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41396402Evening Snack Tier I Meals Served7N(7,0)NIf not claiming Tier I, leave blank
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42403409Evening Snack Tier II High Meals Served7N(7,0)NIf not claiming Tier II High, leave blank
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43410416Evening Snack Tier II Low Meals Served7N(7,0)NIf not claiming Tier II Low, leave blank
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