Heading

Description

Type, Size

Comments & Examples

LASTNAME

Recipient last name

Text, 30

Required

FIRSTNAME

Recipient first name

Text, 30

INITIAL

Recipient initial

Text, 1

ADDRESS1

Address line 1

Text, 50

ADDRESS2

Address line 2

Text, 50

CITY

City

Text, 28

PROV

Province code

Text, 2

POSTAL

Postal code (including space)

Text, 10

COUNTRY

Country code

Text, 3

SIN

S.I.N. of beneficiary

Numeric, 9

YEAR

Taxation year

Numeric, 4

2024

REPORTCODE

Report code

Text, 1

R - Original

A - Amended or

D - Cancelled

BOXA

Social assistance payments (A)

Currency

BOXB

Other government financial assistance (B)

Currency

BOXC

Workers' compensation received from CNESST (C)

Currency

BOXD

Indemnities from SAAQ (D)

Currency

BOXE

Other income (E)

Currency

BOXH

Total repayment of social assistance payments (H)

Currency

BOXI

Repayments related to a year before 1998 (I)

Currency

BOXJ

Allowance for childcare expenses (J)

Currency

BOXK

Other financial aid (K)

Currency

BOXM

Adjustment for income replacement indemnities (M)

Currency

BOXOYEAR1

Adj. for indemnities for previous years (Year 1)

Numeric, 4

BOXOAMT1

Adj. for indemnities for previous years (Amount 1)

Currency

BOXOYEAR2

Adj. for indemnities for previous years (Year 2)

Numeric, 4

BOXOAMT2

Adj. for indemnities for previous years (Amount 2)

Currency

BOXOYEAR3

Adj. for indemnities for previous years (Year 3)

Numeric, 4

BOXOAMT3

Adj. for indemnities for previous years (Amount 3)

Currency

BOXP

Repayment of indemnities (Q)

Currency

BOXQ

Recipient of PSS (Q)

Text, 1

O - Yes

N - No

BOXR1

Recipient for 36 months (R 1)

Text, 1

O - Yes

N - No

BOXS1

Claim slip (S 1)

Text, 1

O - Yes

N - No

BOXT1

Start of the period of transition to work (T 1)

Date, 6

YYYYMM

BOXU1

Resumption of financial assistance (U 1)

Date, 6

YYYYMM

BOXV1

Number of months (V 1)

Numeric, 2

BOXR2

Recipient for 36 months (R 2)

Text, 1

O - Yes

N - No

BOXS2

Claim slip (S 2)

Text, 1

O - Yes

N - No

BOXT2

Start of the period of transition to work (T 2)

Date, 6

YYYYMM

BOXU2

Resumption of financial assistance (U 2)

Date, 6

YYYYMM

BOXV2

Number of months (V 2)

Numeric, 2

BOXR3

Recipient for 36 months (R 3)

Text, 1

O - Yes

N - No

BOXS3

Claim slip (S 3)

Text, 2

O - Yes

N - No

BOXT3

Start of the period of transition to work (T 3)

Date, 6

YYYYMM

BOXU3

Resumption of financial assistance (U 3)

Date, 6

YYYYMM

BOXV3

Number of months (V 3)

Numeric, 2

FILENUMBER

File number or ID number of the recipient

Text, 15

HEALTHINSNUMBER

Health insurance number of the recipient

Text, 12

BIRTHDATE

Birthdate of recipient

Date

MMMM dd, yyyy

SEX

Sex of recipient

Text, 1

1 - Male

2 - Female

CIVILSTATUS

Civil status of recipient

Text, 1

0 - None

1 - Single

2 - Married

3 - Separated

4 - Divorced

5 - Widowed

6 - Religious

7 - Common-law

FILETYPE

Type of file

Text, 1

A - Administered

S - Estate

C - Other

ENDDATEBENEFITS

End date of benefits

Date

MMMM dd, yyyy

RECIPIENTCODE

Recipient code

Text, 1

1 - Last resort assistance

2 - Indian

3 - Housing allowance

VALUEGOODS

Value of goods

Currency

CHILDREN0TO18

Number of children 0 to 18 years

Numeric, 2

CHILDREN18PLUS

Number of children 18 and up

Numeric, 2

MONTHSBENEFITSPAID

Number of months benefits were paid

Numeric, 2

TEXTATTOP

Optional text to print on the slip

Text, 40

EMAILADDRESS

Recipient email address

Text, 255

eForms Enterprise only

One email address, or two separated by a semi-colon

OKTOEMAILSLIP

Permission granted to email slip

Yes/No

eForms Enterprise only

SERIAL

Current Relevé 5 number

Numeric, 9

SERIALMM

Electronic Relevé 5 number

Numeric, 9

SERIALMMPREVIOUS

Sequential (Relevé) number of the slip being amended

Numeric, 9

SERIALORIGINAL

Previous Relevé 5 number

Numeric, 9

SLIPTAG

Subset tag

Text, 10

eForms Enterprise only

CUSTOMFIELD

GUID or other unique identifier

Text, 50

eForms Enterprise only

CUSTOMPASSWORD

Password for recipient PDF slip

Text, 20

eForms Enterprise only