This is the template that should be used to assemble your data. Data should be provided for any employee actively employed at any point during the calendar year. Multiple employee records may be provided due to entity changes, multiple periods of employment within the same calendar year, job status changes within the same calendar year, and/or benefit eligibility or election changes within the same calendar year. All data points are REQUIRED, when applicable, unless otherwise stated. If you do not need state reporting, leave the State Filing column blank. Othewise, acceptable values are CA, DC, NJ or RI.