ET0 |
| Yes | Yes | ALLEVIDENCE |
DET0026022 |
| No | Yes | |
DET0026020 |
| No | Yes | |
DET0026012 |
| No | Yes | |
DET0026011 |
| No | Yes | |
DET0026010 |
| No | Yes | |
DET0026013 |
| No | Yes | |
DET0026014 |
| No | Yes | |
DET0026018 |
| No | Yes | |
DET0026019 |
| No | Yes | |
DET0026016 |
Self-Employment Income (en) |
| No | Yes | |
DET0026000 |
| No | Yes | |
DET0026002 |
| No | Yes | |
DET0026006 |
| No | Yes | |
DET0026007 |
| No | Yes | |
DET0026008 |
| No | Yes | |
DET0026009 |
Insurance Policy Details (en) |
| No | Yes | |
DET0026031 |
| No | Yes | |
DET0026030 |
| No | Yes | |
DET0026028 |
| No | Yes | |
DET0026034 |
| No | Yes | |
DET0026032 |
| No | Yes | |
DET0026026 |
| No | Yes | |
DET0026025 |
| No | Yes | |
DET0026027 |
| No | Yes | |
DET0026024 |
| No | Yes | |
DET0026023 |
| No | Yes | |
DET0026040 |
| No | Yes | |
DET0026041 |
| No | Yes | |
DET0026039 |
| No | Yes | |
DET0026042 |
| No | Yes | |
DET0026036 |
Social Security Number (en) |
| No | Yes | |
DET0026043 |
| No | Yes | |
DET0026044 |
Incarceration Details (en) |
| No | Yes | |
DET0026045 |
| No | Yes | |
DET0026046 |
| No | Yes | |
DET0026047 |
Tax Household Member (en) |
| No | Yes | |
DET0026048 |
| No | Yes | |
DET0026049 |
| No | Yes | |
DET0026050 |
| No | Yes | |
DET0026051 |
| No | Yes | |
DET0026052 |
| No | Yes | |
DET0026053 |
Employer Sponsored Coverage (en) |
| No | Yes | |
DET0026054 |
| No | Yes | |
DET0026055 |
| No | Yes | |
DET0026056 |
Authorization Details (en) |
| No | Yes | |
DET0026057 |
| No | Yes | |
DET0026029 |
Minimum Essential Coverage (en) |
| No | Yes | |
DET0026059 |
| No | Yes | |
DET0026060 |
| No | Yes | |
DET0026061 |
Religious Sect Membership (en) |
| No | Yes | |
DET0026062 |
Health care Sharing Ministry Membership (en) |
| No | Yes | |
DET0026063 |
| No | Yes | |
DET0026064 |
Projected Annual Income (en) |
| No | Yes | |
DET0026065 |
| No | Yes | |
DET0026066 |
| No | Yes | |
DET0026067 |
| No | Yes | |
DET0026068 |
| No | Yes | |
DET0026800 |
Non MAGI Medicaid Eligibility (en) |
| No | Yes | |
DET0026069 |
Employer Sponsored Insurance (en) |
| No | Yes | |
DET0026070 |
Application Filer Consent (en) |
| No | Yes | |
DET0026071 |
| No | Yes | |
DET0026073 |
| No | Yes | |
DET0000257 |
Household Relationship (en) |
| No | Yes | |
DET0000258 |
Countable Assistance Period (en) |
| No | Yes | |
DET0000256 |
IS Medicaid Eligibility (en) |
| No | Yes | |
DET0000259 |
| No | Yes | |
ET50 |
| No | Yes | ISPABSENTPARENT |
ET51 |
Absent Parent Child Support (en) |
| No | Yes | ISPABSENTPARENTCHILDSUPPORT |
ET52 |
Provider Utilisation Evidence (en_GB) |
| No | Yes | ISPALIEN |
ET53 |
| No | Yes | ISPALIENSPONSOR |
ET54 |
| No | Yes | ISPALIENSPONSORSHIP |
ET55 |
Authorized Representative (en) |
Authorised Representative (en_GB) |
| No | Yes | ISPAUTHORIZEDREPRESENTATIVE |
ET56 |
| No | Yes | ISPBOARDER |
ET57 |
| No | Yes | BURIALPLAN |
ET58 |
| No | Yes | ISPBURIALPLOT |
ET59 |
Child Support Expense (en) |
| No | Yes | ISPCHILDSUPPORTEXPENSE |
ET60 |
Child Immunisation (en_GB) |
| No | Yes | CHILDIMMUNE |
ET61 |
Child Support Enforcement (en) |
| No | Yes | ISPCHILDSUPPORTENFORCEMENT |
ET62 |
| No | Yes | CRIMINALHISTORY |
ET63 |
Dependent Care Expense (en) |
Dependant Care Expense (en_GB) |
| No | Yes | ISPDEPENDANTCASEEXPENSE |
ET64 |
| No | Yes | ISPDISABILITY |
ET65 |
| No | Yes | ISPEMPLOYMENTEXPENSE |
ET66 |
| No | Yes | ISPHOUSEHOLDMEMBER |
ET67 |
| No | Yes | ISPLIFEINSURANCE |
ET68 |
| No | Yes | LIQUIDRESOURCES |
ET69 |
| No | Yes | ISPLIVINGARRANGEMENT |
ET70 |
| No | Yes | ISPMEDICALEXPENSE |
ET71 |
Minor Parent NonResidency (en) |
| No | Yes | ISPMINORPARENTNONRESIDENCY |
ET72 |
Minor Parent School Attendance (en) |
| No | Yes | MINORPARENTSCHOOLATTENDANCE |
ET73 |
| No | Yes | ISPOWNERSHIP |
ET74 |
| No | Yes | ISPPREGNANCYDETAILS |
ET75 |
| No | Yes | PROPERTY |
ET76 |
| No | Yes | RESOURCETRANSFER |
ET77 |
| No | Yes | SHELTEREXPENSE |
ET78 |
| No | Yes | ISPSTUDENT |
ET79 |
| No | Yes | ISPSTUDENTEXPENSE |
ET80 |
| No | Yes | ABSENCE |
ET81 |
| No | Yes | ISPVEHICLE |
ET82 |
Veteran Military Service (en) |
| No | Yes | VETERANMILITARYSERVICE |
ET83 |
| No | Yes | ISPVOLUNTARYQUIT |
ET86 |
| No | Yes | ISPABAWD |
ET87 |
| No | Yes | ISPDEPRIVATION |
ET88 |
| No | Yes | FOSTERCARE |
ET90 |
Household Relationship (en) |
| No | Yes | HOUSEHOLDRELATIONSHIP |
ET92 |
| No | Yes | ISPWORKREQUIREMENTS |
ET93 |
| No | Yes | ISPBENEFITINCOME |
ET95 |
| No | Yes | ISPEARNEDINCOME |
ET96 |
| No | Yes | ISPEMPLOYMENTOFFER |
ET97 |
Paid Employment Income (en) |
| No | Yes | ISPPAIDEMPLOYMENTINCOME |
ET99 |
| No | Yes | ISPTRADEDISPUTE |
ET100 |
| No | Yes | ISPUNEARNEDINCOME |
ET101 |
| No | Yes | UNPAIDEMPLOYMENT |
ET103 |
| No | Yes | UTILITYEXPENSE |
ET105 |
| No | Yes | DOMESTICVIOLENCE |
ET106 |
| No | Yes | ISPHOUSEHOLDMEALS |
ET107 |
| No | Yes | ISPHEADOFHOUSEHOLD |
ET111 |
| No | Yes | ASSISTANCEHISTORY |
ET112 |
| No | Yes | SELFEMPLOYMENT |
ET113 |
| No | Yes | ANTICIPATEDINCOME |
ET114 |
| No | Yes | ISPCOURTORDER |
ET115 |
Household Meals Group (en) |
| No | Yes | HHOLDMEALSGROUP |
ET116 |
Household Meals Group Member (en) |
| No | Yes | MEALSGROUPMEMBER |
ET117 |
| No | Yes | ISPALIMONY |
ET118 |
Third Party Liability Enforcement (en) |
| No | Yes | ISPTPLENFORCEMENT |
ET119 |
| No | Yes | ISPADOPTION |
ET120 |
| No | Yes | ISPADOPTIONPAYMENT |
ET121 |
| No | Yes | ISPTRUST |
ET122 |
| No | Yes | FOSTERCAREPAYMENT |
ET123 |
| No | Yes | LIVINGEXPENSE |
ET124 |
| No | Yes | ABSENTPARENTCSE |
ET125 |
| No | Yes | ISPUNBORNCHILD |
ET126 |
| No | Yes | CONTRIBUTOR |
ET127 |
| No | Yes | GROSSRECEIPT |
ET128 |
| No | Yes | RESOURCEINCOME |
ET129 |
| No | Yes | INCOMEREPORTING |
ET130 |
| No | Yes | ISPTRUSTINCOME |
ET131 |
| No | Yes | ISPMEDICALINSURANCE |
ET132 |
| No | Yes | ISPTRUSTEE |
ET133 |
| No | Yes | BUSINESSASSET |
ET134 |
| No | Yes | ISPBENEFICIARY |
ET135 |
| No | Yes | ISPCOVERAGE |
ET136 |
Unearned Rental Income Expenses (en) |
| No | Yes | ISPUNEARNEDRENTALINCOMEEXPENSES |
ET137 |
| No | Yes | ISPINCOMEALLOCATION |
ET138 |
Medical Expense Payment (en) |
| No | Yes | ISPMEDICALEXPENSEPAYMENT |
ET139 |
SpendDown Medical Expense (en) |
| No | Yes | ISPSPENDDOWNMEDICALEXPENSE |
ET140 |
| No | Yes | ISPPAYIN |
ET141 |
| No | Yes | ISPGENERALINSURANCE |
ET142 |
Elective CHIP Enrollee (en) |
| No | Yes | ELECTIVECHIPENROLLEE |
ET143 |
Medical Insurance Entitlement Details (en) |
| No | Yes | ISPENTITLEMENT |
ET144 |
Coverage Type Details (en) |
| No | Yes | ISPCOVERAGETYPEDETAILS |
ET145 |
| No | Yes | ISPLEVELOFCARE |
ET146 |
| No | Yes | ISPANNUITY |
ET147 |
| No | Yes | ISPMEDICALINSTITUTION |
ET148 |
Cost of Care Allowance (en) |
| No | Yes | ISPCOSTOFCAREALLOWANCE |
ET149 |
| No | Yes | ISPSPOUSALCOOPERATION |
ET150 |
| No | Yes | ISPANNUITYBENEFICIARY |
ET151 |
| No | Yes | ISPMEDICALSCREENING |
ET152 |
| No | Yes | ISPANNUITYINCOME |
ET156 |
Income Trust Schedule (en) |
| No | Yes | ISPINCOMETRUSTSCHEDULE |
ET153 |
Legal Guardian Expense (en) |
| No | Yes | LEGALGUARDIANEXPENSE |
ET154 |
| No | Yes | ISPEMERGENCY |
ET155 |
Medical Institution Temporary Absence (en) |
| No | Yes | ISPMEDICALINSTITUTIONTEMPORARYABSENCE |
ET157 |
| No | Yes | ISPASSIGNEDINCOME |
ET158 |
Spousal Impoverishment (en) |
| No | Yes | ISPSPOUSALIMPOVERISHMENT |
ET159 |
Transfer Sanction Link (en) |
| No | Yes | ISPTRANSFERSANCTIONLINK |
ET10050 |
| No | Yes | |
ET10051 |
Absent Parent Child Support (en) |
| No | Yes | |
ET10052 |
Provider Utilisation Evidence (en_GB) |
| No | Yes | |
ET10053 |
| No | Yes | |
ET10054 |
| No | Yes | |
ET10055 |
Authorized Representative (en) |
Authorised Representative (en_GB) |
| No | Yes | |
ET10056 |
| No | Yes | |
ET10057 |
| No | Yes | |
ET10058 |
| No | Yes | |
ET10059 |
Child Support Expense (en) |
| No | Yes | |
ET10060 |
Child Immunisation (en_GB) |
| No | Yes | |
ET10061 |
Child Support Enforcement (en) |
| No | Yes | |
ET10062 |
| No | Yes | |
ET10063 |
Dependent Care Expense (en) |
Dependant Care Expense (en_GB) |
| No | Yes | |
ET10064 |
| No | Yes | |
ET10065 |
| No | Yes | |
ET10066 |
| No | Yes | |
ET10067 |
| No | Yes | |
ET10068 |
| No | Yes | |
ET10069 |
| No | Yes | |
ET10070 |
| No | Yes | |
ET10071 |
Minor Parent NonResidency (en) |
| No | Yes | |
ET10072 |
Minor Parent School Attendance (en) |
| No | Yes | |
ET10073 |
| No | Yes | |
ET10074 |
| No | Yes | |
ET10075 |
| No | Yes | |
ET10076 |
| No | Yes | |
ET10077 |
| No | Yes | |
ET10078 |
| No | Yes | |
ET10079 |
| No | Yes | |
ET10080 |
| No | Yes | |
ET10081 |
| No | Yes | |
ET10082 |
Veteran Military Service (en) |
| No | Yes | |
ET10083 |
| No | Yes | |
ET10086 |
| No | Yes | |
ET10087 |
| No | Yes | |
ET10088 |
| No | Yes | |
ET10090 |
Household Relationship (en) |
| No | Yes | |
ET10092 |
| No | Yes | |
ET10093 |
| No | Yes | |
ET10095 |
| No | Yes | |
ET10096 |
| No | Yes | |
ET10097 |
Paid Employment Income (en) |
| No | Yes | |
ET10099 |
| No | Yes | |
ET10100 |
| No | Yes | |
ET10101 |
| No | Yes | |
ET10103 |
| No | Yes | |
ET10105 |
| No | Yes | |
ET10106 |
| No | Yes | |
ET10107 |
| No | Yes | |
ET10111 |
| No | Yes | |
ET10112 |
| No | Yes | |
ET10113 |
| No | Yes | |
ET10114 |
| No | Yes | |
ET10115 |
Household Meals Group (en) |
| No | Yes | |
ET10116 |
Household Meals Group Member (en) |
| No | Yes | |
ET10117 |
| No | Yes | |
ET10118 |
Third Party Liability Enforcement (en) |
| No | Yes | |
ET10119 |
| No | Yes | |
ET10120 |
| No | Yes | |
ET10121 |
| No | Yes | |
ET10122 |
| No | Yes | |
ET10123 |
| No | Yes | |
ET10124 |
| No | Yes | |
ET10125 |
| No | Yes | |
ET10126 |
| No | Yes | |
ET10127 |
| No | Yes | |
ET10128 |
| No | Yes | |
ET10129 |
| No | Yes | |
ET10130 |
| No | Yes | |
ET10131 |
| No | Yes | |
ET10132 |
| No | Yes | |
ET10133 |
| No | Yes | |
ET10134 |
| No | Yes | |
ET10135 |
| No | Yes | |
ET10136 |
Unearned Rental Income Expenses (en) |
| No | Yes | |
ET10137 |
| No | Yes | |
ET10138 |
Medical Expense Payment (en) |
| No | Yes | |
ET10139 |
SpendDown Medical Expense (en) |
| No | Yes | |
ET10140 |
| No | Yes | |
ET10141 |
| No | Yes | |
ET10142 |
Elective CHIP Enrollee (en) |
| No | Yes | |
ET10143 |
Medical Insurance Entitlement Details (en) |
| No | Yes | |
ET10144 |
Coverage Type Details (en) |
| No | Yes | |
ET10145 |
| No | Yes | |
ET10146 |
| No | Yes | |
ET10147 |
| No | Yes | |
ET10148 |
Cost of Care Allowance (en) |
| No | Yes | |
ET10149 |
| No | Yes | |
ET10150 |
| No | Yes | |
ET10151 |
| No | Yes | |
ET10152 |
| No | Yes | |
ET10156 |
Income Trust Schedule (en) |
| No | Yes | |
ET10153 |
Legal Guardian Expense (en) |
| No | Yes | |
ET10154 |
| No | Yes | |
ET10155 |
Medical Institution Temporary Absence (en) |
| No | Yes | |
ET10157 |
| No | Yes | |
ET10158 |
Spousal Impoverishment (en) |
| No | Yes | |
ET10159 |
Transfer Sanction Link (en) |
| No | Yes | |
ET160 |
| No | Yes | EXEMPTION |
ET161 |
| No | Yes | OUTOFSTATEMONTH |
ET163 |
Countable Assistance History (en) |
| No | Yes | COUNTABLEASSISTANCEHISTORY |
ET162 |
| No | Yes | EXTENSION |
ET3004 |
Provider Attendance Evidence (en) |
| No | Yes | |
PDC0000262 |
| No | Yes | |
PDC0000261 |
| No | Yes | |
PDC0000260 |
| No | Yes | |
PDC0000258 |
| No | Yes | |
PDC0000259 |
| No | Yes | |
PDC0000256 |
| No | Yes | |
PDC0000257 |
| No | Yes | |
PDC0000263 |
| No | Yes | |
PDC0000264 |
Birth and Death Details (en) |
| No | Yes | |
PDC0000265 |
| No | Yes | |
ET1 |
Sickness Benefit Evidence (en) |
| No | No | SICKNESSBENEFIT |
ET3 |
| No | No | TRAINING |
ET6 |
Relationship Evidence (en) |
| No | Yes | RELATIONSHIP |
ET8 |
Employer Contribution Evidence (en) |
| No | No | EMPCON |
ET9 |
Overpayment Evidence (en) |
| No | Yes | OVERPAYMENT |
ET10 |
Underpayment Evidence (en) |
| No | Yes | |
ET11 |
Contribution Training Evidence (en) |
| No | No | CON_TRAINING |
ET12 |
| No | No | LOAN |
ET13 |
| No | No | DRAWDOWN |
ET14 |
| No | No | REPAYMENT |
ET15 |
Unemployment Benefit Evidence (en) |
| No | No | UNEMPLOYMENTBENEFIT |
ET16 |
| No | No | HEALTHGRANT |
ET17 |
| No | No | HEALTHGRANTVISIT |
ET18 |
Ad hoc Bonus Payment (en) |
| No | Yes | ADHOCBONUSPAYMENT |
ET19 |
| No | No | DUACOREEVIDENCE |
ET20 |
DUA Earning Since Disaster (en) |
| No | No | DUAEARNINGSINCEDISASTER |
ET21 |
DUA Client Previous Year Earning (en) |
| No | No | DUACLIENTPREVIOUSYEAREARNING |
ET22 |
DUA Deceased Previous Year Earning (en) |
| No | No | DUADECEASEDPREVIOUSYEAREARNING |
ET23 |
DUA User Override Evidence (en) |
| No | No | DUAUSEROVERRIDEEVIDENCE |
ET30 |
| No | No | SIMPLEPRODUCT |
ET31 |
| No | Yes | HOUSEHOLDEVIDENCE |
ET32 |
| No | Yes | INCOMEEVIDENCE |
ET33 |
| No | Yes | BENEFITEVIDENCE |
ET34 |
| No | Yes | RESOURCEEVIDENCE |
ET35 |
| No | Yes | EXPENSEEVIDENCE |
ET36 |
Simple Liability Product (en) |
| No | No | SIMPLELIABILITYPRODUCT |
ET37 |
IS Household Evidence (en) |
| No | Yes | ISHOUSEHOLDEVIDENCE |
ET38 |
| No | Yes | ISBENEFITEVIDENCE |
ET39 |
IS Medicaid Evidence (en) |
| No | Yes | ISMEDICAIDEVIDENCE |
ET40 |
| No | Yes | ISINCOMEEVIDENCE |
ET41 |
IS Resource Evidence (en) |
| No | Yes | ISRESOURCEEVIDENCE |
ET42 |
IS Shelter Expense Evidence (en) |
| No | Yes | ISSHELTEREXPEVIDENCE |
ET43 |
IS Medical Expense Evidence (en) |
| No | Yes | ISMEDICALEXPEVIDENCE |
ET44 |
IS Dependent Care Expense Evidence (en) |
| No | Yes | ISDEPCAREEXPEVIDENCE |
ET45 |
IS Relationship Evidence (en) |
| No | Yes | ISRSHIPEVIDENCE |
ET46 |
IS Emergency Assistance Evidence (en) |
| No | Yes | ISEAEVIDENCE |
ET47 |
Benefit Underpayment Evidence (en) |
| No | Yes | BENEFITUNDERPAYMENT |
ET2 |
Liability Overbilling Evidence (en) |
| No | Yes | OVERBILLING |
ET500 |
Sample Sporting Activity Evidence (en) |
| No | No | SAMPLESPORTINGACTIVITY |
ET501 |
Sample Sporting Activity Expense Evidence (en) |
| No | No | SAMPLESPORTINGACTIVITYEXPENSE |
ET502 |
Sample Sporting Sponsorship Evidence (en) |
| No | No | SPORTINGSPONSORSHIP |
PET1 |
| No | Yes | EMPLOYER |
PET2 |
| No | Yes | PERSON |
PET3 |
| No | Yes | CONCERNROLE |
PET4 |
| No | Yes | CITIZENSHIP |
PET5 |
| No | Yes | CONCERNROLEADDRESS |
PET6 |
| No | Yes | ALTERNATENAME |
PET7 |
| No | Yes | EMPLOYMENT |
PET8 |
Employment Working Hours (en) |
| No | Yes | EMPLOYMENTWORKINGHR |
PET9 |
| No | Yes | EDUCATION |
PET10 |
| No | Yes | CONCERNROLEBANKACC |
PET11 |
| No | Yes | CONCERNROLERELATIONSHIP |
PET12 |
| No | Yes | FOREIGNRESIDENCY |
PET13 |
Prospect Person Details (en) |
| No | Yes | PROSPECTPERSON |
PET14 |
Prospect Employer Details (en) |
| No | Yes | PROSPECTEMPLOYER |
PET15 |
| No | Yes | CONCERNROLEALTERNATEID |