Attachment_8_4a_Data_Entry_Field_Enumeration_(06_17_14)_Page_17.pdf

Attachment 8.4a – Data Entry Field Enumeration

18: I‐730 (Data Field Count‐44) – X

DATA ITEM DATA ITEM

1 Received Date 23 Relative A‐ Number

2 A‐Number 24 Relative Last Name

3 Last Name 25 First Name

4 First Name 26 Middle Name

5 Middle Name 27 C/O

6 C/O 28 Street Number/Name

7 Street Number/Name 29 Apt. #

8 Apt. # 30 City

9 City 31 State

10 State 32 Zip

11 Zip 33 Province

12 Province 34 Postal Code

13 Postal Code 35 Country

14 Country 36 DOB

15 DOB 37 COB

16 COB 38 Relationship

17 COC 39 COC

18 SS Number 40 SS Number

19 Status 41 DOA

20 Number of Relatives 42 I‐94 Number

21 Signature 43 Current Status

22 G‐28 44 Status Expires On

Note: I‐730 may be filed with multiple beneficiaries or children. Each named beneficiary or child requires up to 8 additional fields. See Attachment 8.4b for additional data fields required.