Form 4572 - Electronic Filing Trading Partner Agreement (Tpa) Page 10

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Type ‘6’ Record
Field
Data Element
Field Req.
Type
Length
Value
Name
M=Mandatory
O= Optional
R= Required
1
Record Type
M
Numeric
1
‘6’
Code
2
Transaction
M
Numeric
2
Credit payment = ‘22’ Pre-
Code
Note = ‘23’ Zero = ‘24’ (Note:
Code ‘24’ is for Tax Type
Code 0115A only. See page 7
or Page 12).
3
Receiving DGI
M
TTTTAAAA
8
Withholding and Corporate
Identifier
Value = ‘08650717’ Sales
Value = 08650063
4
Check Digit
M
Numeric
1
‘4’
5
RDFI Account
R
Alphanumeric
17
Withholding Value = ‘8600500’
Number
Corporate Value = ‘8600505’
Sales Value = ‘1015540’
6
Amount $
M
N2
10
$$$$$$$$CC (Amount of
Payment
7
Identification
M
Alphanumeric
15
Withholding Value = ‘0115000’
Number
+ Missouri Tax ID Number.
Corporate Value = ‘0219000’ +
Missouri Tax ID Number.
Sales Value = ‘0420000’ +
Missouri Tax ID Number.
8
Receiving
M
Alphanumeric
22
‘MO Dept of Revenue
’
Company Name
9
Discretionary
O
Alphanumeric
2
Spaces
Data
10
Addenda
M
Numeric
1
‘1’
Record
Indicator
11
Trace Number
M
Numeric
15
First 8 digits of Originator
Routing Number + 7 digit
Trace Number.
End of Type ‘6’ Record.
10

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