| Label | Type | Description | Mandatory |
| Updated On | CURAM_DATETIME | The date on which the last update was made to the evidence. | No |
| Effective Date of Change | CURAM_DATE | Date which the evidence becomes effective | No |
| Approval Requested | CURAM_INDICATOR | Approval Requested | No |
| Assignee | FULL_NAME | Drop-down list containing household members and their social security numbers. If the household member does not have a social security number, no number is displayed. | No |
| Assign Third Party Payment Rights | CURAM_INDICATOR | Indicator to show whether or not the household member has assigned their third party payment rights to the state. | No |
| Cooperate With TPL Requirements | CURAM_INDICATOR | Indicator to show whether or not the household member has agreed to cooperate with the state in obtaining any possible third party payments. | No |
| Non Compliance Reason | EVD_TPL_NON_COMPLIANCE_REASON | Drop-down list containing reasons why the household member may not be complying with TPL Requirements. The requirement to comply may be waived when the household member has good cause not to cooperate. Examples of acceptable reasons include serious illness or death in the family, family emergency or household disaster, such as a fire, flood or tornado. Your system administrator can add a non-compliance reason via the Code Tables page (see "Code Tables" in the Cúram Administration Guide). | No |
|
| Updated By |
| Label | Type | Description | Mandatory |
| Updated By | USER_NAME | | No |
|
|
|
| Third Party Liability Enforcement Evidence Details |
| Label | Type | Description | Mandatory |
| Household Member | FULL_NAME | Drop-down list containing household members and their social security numbers. If the household member does not have a social security number, no number is displayed. | No |
|
| Comments |
| Label | Type | Description | Mandatory |
| Comments | COMMENTS | | No |
|
