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Updated On[date-and-time]Received Date[Date]
Effective Date of Change[Date]Change Reason[field-value]
Approval Requested[True]Approval Status[Approved]
Status[Active]Updated By[User Name]

Benefit Details

Participant[Full Name] 
Benefit Type[field-value] 
Start Date[Date] 
End Date[Date] 
End Reason[field-value] 
State[field-value] 
Application Date[Date] 
Last Payment Date[Date] 

Delivery Details

Amount[Amount]Frequency[Daily]
Delivery Type[field-value]Pay Day[field-value]
Rate Payable[Amount] 

Other Benefit Details

Aid Mobility Indicator[True]Public Office[Office Name]
Aid Personal Care Indicator[True]Indian Country Indicator[True]
Benefit Usage[field-value] 

Deduction Details

Deduction Type[field-value]Deduction Amount[Amount]

Comments

[Comments]