IMPLEMENTATION GUIDELINES FOR ANSI ASC X12 EDI CONVENTIONS MAJOR DAMAGE TRACKING PAYMENT ORDER/REMITTANCE ADVICE (820) TRANSACTION SET

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IMPLEMENTATION GUIDELINES FOR ANSI ASC X12 EDI CONVENTIONS MAJOR DAMAGE TRACKING PAYMENT ORDER/REMITTANCE ADVICE (820) TRANSACTION SET FCA US INFORMATION & COMMUNICATION TECHNOLOGY MANAGEMENT ANSI ASC X12 VERSION/RELEASE 003030

820 Payment Order/Remittance Advice Functional Group ID=RA Introduction: This Draft Standard for Trial Use contains the format and establishes the data contents of the Payment Order/Remittance Advice Transaction Set (820) for use within the context of an Electronic Data Interchange (EDI) environment. The transaction set can be used to make a payment, send a remittance advice, or make a payment and send a remittance advice. This transaction set can be an order to a financial institution to make a payment to a payee. It can also be a remittance advice identifying the detail needed to perform cash application to the payee's accounts receivable system. The remittance advice can go directly from payer to payee, through a financial institution, or through a third party agent. Notes: History of Change: 07/08/2010: Original Guide Creation 01/28/2015: Name Change To FCA US Heading: Page Pos. Seg. Base User Loop Notes and No. No. ID Name Guide Status Max.Use Repeat Comments 5 010 ST Transaction Set Header M M 1 6 020 BPR Beginning Segment for Payment M M 1 Order/Remittance Advice 030 NTE Note/Special Instruction O Not >1 035 TRN Trace O Not 1 c1 040 CUR Currency O Not 1 c2 8 050 REF Reference Numbers O >1 060 DTM Date/Time/Period O Not >1 LOOP ID - N1 >1 9 070 N1 Name O 1 c3 080 N2 Additional Name Information O Not >1 10 090 N3 Address Information O >1 11 100 N4 Geographic Location O 1 110 REF Reference Numbers O Not >1 120 PER Administrative Communications Contact O Not >1 Detail: Page Pos. Seg. Base User Loop Notes and 01/28/2015 V/R 003030 1 FCA US

No. No. ID Name Guide Status Max.Use Repeat Comments LOOP ID - ENT >1 12 010 ENT Entity O 1 c4 LOOP ID - N1 >1 020 N1 Name O Not 1 c5 030 N2 Additional Name Information O Not >1 040 N3 Address Information O Not >1 050 N4 Geographic Location O Not 1 060 REF Reference Numbers O Not >1 070 PER Administrative Communications Contact O Not >1 LOOP ID - ADX >1 080 ADX Adjustment O Not 1 c6 090 NTE Note/Special Instruction O Not >1 100 PER Administrative Communications Contact O Not >1 LOOP ID - REF >1 110 REF Reference Numbers O Not 1 120 DTM Date/Time/Period O Not >1 LOOP ID - IT1 >1 130 IT1 Baseline Item Data (Invoice) O Not 1 c7 LOOP ID - REF >1 140 REF Reference Numbers O Not 1 141 DTM Date/Time/Period O Not 1 LOOP ID - ITA >1 142 ITA Allowance, Charge or Service O Not 1 143 TXI Tax Information O Not >1 LOOP ID - SLN >1 144 SLN Subline Item Detail O Not 1 LOOP ID - REF >1 145 REF Reference Numbers O Not 1 146 DTM Date/Time/Period O Not >1 LOOP ID - ITA >1 147 ITA Allowance, Charge or Service O Not 1 148 TXI Tax Information O Not >1 LOOP ID - RMR >1 14 150 RMR Remittance Advice Accounts Receivable Open Item Reference O 1 c8 160 NTE Note/Special Instruction O Not >1 15 170 REF Reference Numbers O >1 180 DTM Date/Time/Period O Not >1 LOOP ID - IT1 >1 190 IT1 Baseline Item Data (Invoice) O Not 1 c9 LOOP ID - REF >1 200 REF Reference Numbers O Not 1 201 DTM Date/Time/Period O Not 1 01/28/2015 V/R 003030 2 FCA US

LOOP ID - ITA >1 202 ITA Allowance, Charge or Service O Not 1 203 TXI Tax Information O Not >1 LOOP ID - SLN >1 204 SLN Subline Item Detail O Not 1 LOOP ID - REF >1 205 REF Reference Numbers O Not 1 206 DTM Date/Time/Period O Not >1 LOOP ID - ITA >1 207 ITA Allowance, Charge or Service O Not 1 208 TXI Tax Information O Not >1 LOOP ID - ADX >1 210 ADX Adjustment O Not 1 c10 220 NTE Note/Special Instruction O Not >1 230 PER Administrative Communications Contact O Not >1 LOOP ID - REF >1 240 REF Reference Numbers O Not 1 250 DTM Date/Time/Period O Not >1 LOOP ID - IT1 >1 260 IT1 Baseline Item Data (Invoice) O Not 1 c11 LOOP ID - REF >1 270 REF Reference Numbers O Not 1 271 DTM Date/Time/Period O Not 1 LOOP ID - ITA >1 272 ITA Allowance, Charge or Service O Not 1 273 TXI Tax Information O Not >1 LOOP ID - SLN >1 274 SLN Subline Item Detail O Not 1 LOOP ID - REF >1 275 REF Reference Numbers O Not 1 276 DTM Date/Time/Period O Not >1 LOOP ID - ITA >1 277 ITA Allowance, Charge or Service O Not 1 278 TXI Tax Information O Not >1 LOOP ID - TXP >1 280 TXP Tax Payment O Not 1 285 TXI Tax Information O Not >1 Summary: Page Pos. Seg. Base User Loop Notes and No. No. ID Name Guide Status Max.Use Repeat Comments 16 010 SE Transaction Set Trailer M M 1 01/28/2015 V/R 003030 3 FCA US

Transaction Set Comments 1. The TRN segment is used to uniquely identify a payment order/remittance advice. 2. The CUR segment does not initiate a foreign exchange transaction. 3. The N1 loop allows for name/address information for the payer and payee which would be utilized to address remittance(s) for delivery. 4. ENT09 may contain the payee's accounts receivable customer number. 5. Allowing the N1 segment to repeat in this area allows the paying entity within a payer and the paid entity within a payee to be identified (not the payer and payee). 6. This ADX adjustment loop contains adjustment information not related to items referenced by any RMR segment in this transaction (see Comment G). This ADX loop may contain adjustments of any other nature. 7. Loop IT1 within the ADX loop is the adjustment line item detail loop. 8. Loop RMR is for items being paid. 9. Loop IT1 within the RMR loop is the remittance line item detail loop. 10. Loop ADX within the RMR loop is the adjustment loop for the remittance detail in this payment. This adjustment loop can only contain adjustment information for the RMR loop. 11. Loop IT1 within the ADX loop is the adjustment line item detail loop. 01/28/2015 V/R 003030 4 FCA US

Segment: ST Transaction Set Header Position: 010 Loop: Level: Heading Usage: Mandatory Max Use: 1 Purpose: To indicate the start of a transaction set and to assign a control number Syntax Notes: Semantic Notes: 1 The transaction set identifier (ST01) is used by the translation routines of the interchange partners to select the appropriate transaction set definition (e.g., 810 selects the Invoice Transaction Set). Comments: ST01 143 Transaction Set Identifier Code M ID 3/3 M Code uniquely identifying a Transaction Set 820 X12.4 Payment Order/Remittance Advice ST02 329 Transaction Set Control Number M AN 4/9 M Identifying control number that must be unique within the transaction set functional group assigned by the originator for a transaction set 01/28/2015 V/R 003030 5 FCA US

Segment: BPR Beginning Segment for Payment Order/Remittance Advice Position: 020 Loop: Level: Heading Usage: Mandatory Max Use: 1 Purpose: (1) To indicate the beginning of a PaymentOrder/Remittance Advice Transaction Set and total payment amount or (2) to enable related transfer of funds and/or information from payer to payee to occur Syntax Notes: 1 If either BPR06 or BPR07 is present, then the other is required. 2 If BPR08 is present, then BPR09 is required. 3 If either BPR12 or BPR13 is present, then the other is required. 4 If BPR14 is present, then BPR15 is required. Semantic Notes: 1 BPR02 specifies the payment amount. 2 When using this transaction set to initiate a payment, BPR06 through BPR16 may be required, depending on the conventions of the specific financial channel being used. BPR06 and BPR07 relate to the originating depository financial institution (ODFI). 3 BPR12 and BPR13 relate to the receiving depository financial institution (RDFI). 4 BPR15 is the account number of the receiving company to be debited or credited with the payment order. 5 BPR17 is a code identifying the business reason for this payment. Comments: 1 BPR09 is the account of the company originating the payment. This account may be debited or credited depending on the type of payment order. BPR01 305 Transaction Handling Code M ID 1/1 M Code designating the action to be taken by all parties I Remittance Information Only BPR02 782 Monetary Amount M R 1/15 M Monetary amount Total payment amount BPR03 478 Credit/Debit Flag Code M ID 1/1 M Code indicating whether amount is a credit or debit 'C' = credit to receiver and debit to originator. C Credit BPR04 591 Payment Method Code M ID 3/3 M Code used to designate the actual funds transfer method. NON Non-Payment Data BPR05 812 Payment Format Code O ID 1/10 Not BPR06 506 (DFI) ID Number Qualifier X ID 2/2 Not 01/28/2015 V/R 003030 6 FCA US

BPR07 507 (DFI) Identification Number X AN 3/12 Not BPR08 896 Account Number Qualifier Code O ID 2/2 Not BPR09 508 Account Number X AN 1/35 Not BPR10 509 Originating Company Identifier O AN 10/10 Not BPR11 510 Originating Company Supplemental Code O AN 9/9 Not BPR12 506 (DFI) ID Number Qualifier X ID 2/2 Not BPR13 507 (DFI) Identification Number X AN 3/12 Not BPR14 896 Account Number Qualifier Code O ID 2/2 Not BPR15 508 Account Number X AN 1/35 Not BPR16 513 Effective Entry Date O DT 6/6 Not BPR17 1048 Business Function Code O ID 1/3 Not 01/28/2015 V/R 003030 7 FCA US

Segment: REF Reference Numbers Position: 050 Loop: Level: Heading Usage: Optional Max Use: >1 Purpose: To specify identifying numbers. Syntax Notes: 1 At least one of REF02 or REF03 is required. Semantic Notes: Comments: REF01 128 Reference Number Qualifier M ID 2/2 M Code qualifying the Reference Number. 23 Client Number BF Billing Center Identification RN Run Number REF02 127 Reference Number X AN 1/30 Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier. If REF01 = '23', '01538'; If REF01 = 'BF', 'X7179'; If REF01 = 'RN', the Warranty List Number (YYMMx). REF03 352 Description X AN 1/80 Not 01/28/2015 V/R 003030 8 FCA US

Segment: N1 Name Position: 070 Loop: N1 Optional Level: Heading Usage: Optional Max Use: 1 Purpose: To identify a party by type of organization, name, and code Syntax Notes: 1 At least one of N102 or N103 is required. 2 If either N103 or N104 is present, then the other is required. Semantic Notes: Comments: 1 This segment, used alone, provides the most efficient method of providing organizational identification. To obtain this efficiency the "ID Code" (N104) must provide a key to the table maintained by the transaction processing party. N101 98 Entity Identifier Code M ID 2/2 M Code identifying an organizational entity, a physical location, or an individual PE Payee N102 93 Name X AN 1/35 Free-form name Remit to company name (Crawford & Co.) N103 66 Identification Code Qualifier X ID 1/2 Not N104 67 Identification Code X AN 2/17 Not 01/28/2015 V/R 003030 9 FCA US

Segment: N3 Address Information Position: 090 Loop: N1 Optional Level: Heading Usage: Optional Max Use: >1 Purpose: To specify the location of the named party Syntax Notes: Semantic Notes: Comments: N301 166 Address Information M AN 1/35 M Address information Remit to address N302 166 Address Information O AN 1/35 Not 01/28/2015 V/R 003030 10 FCA US

Segment: N4 Geographic Location Position: 100 Loop: N1 Optional Level: Heading Usage: Optional Max Use: 1 Purpose: To specify the geographic place of the named party Syntax Notes: 1 At least one of N401 or N405 is required. 2 If either N405 or N406 is present, then the other is required. Semantic Notes: Comments: 1 A combination of either N401 through N404, or N405 and N406 may be adequate to specify a location. 2 N402 is required only if city name (N401) is in the USA or Canada. N401 19 City Name X AN 2/30 Free-form text for city name N402 156 State or Province Code O ID 2/2 Code (Standard State/Province) as defined by appropriate government agency N403 116 Postal Code O ID 3/9 Code defining international postal zone code excluding punctuation and blanks (zip code for United States) N404 26 Country Code O ID 2/3 Not N405 309 Location Qualifier X ID 1/2 Not N406 310 Location Identifier X AN 1/25 Not 01/28/2015 V/R 003030 11 FCA US

Segment: ENT Entity Position: 010 Loop: ENT Optional Level: Detail Usage: Optional Max Use: 1 Purpose: To designate the entities which are parties to a transaction and specify a reference meaningful to those entities Syntax Notes: 1 If any of ENT02 ENT03 or ENT04 is present, then all are required. 2 If any of ENT05 ENT06 or ENT07 is present, then all are required. 3 If either ENT08 or ENT09 is present, then the other is required. Semantic Notes: Comments: 1 This segment allows for the grouping of data by entity/entities at or within a master/masters. A master (e.g., an organization) can be comprised of numerous subgroups (e.g., entities). This master may send grouped data to another master (e.g., an organization) which is comprised of one or more entities. Groupings are as follows: (1) Single/Single: Only ENT01 is necessary, because there is a single entity (the sending master) communicating with a single entity (the receiving master). (2) Single/Multiple: ENT05, ENT06, and ENT07 would be used to identify the entities within the receiving master. The sending master is a single entity, so no other data elements need be used. (3) Multiple/Single: ENT02, ENT03, and ENT04 would be used to identify the entities within the sending master. The receiving master is a single entity, so no other data elements need be used. (4) Multiple/Multiple: ENT02, ENT03, and ENT04 would be used to identify the entities within the sending master. ENT05, ENT06, and ENT07 would be used to identify the entities within the receiving master. This segment also allows for the transmission of a unique reference number that is meaningful between the entities. ENT01 554 Assigned Number O N0 1/6 Number assigned for differentiation within a transaction set FCA US use: '1'. ENT02 98 Entity Identifier Code X ID 2/2 Not ENT03 66 Identification Code Qualifier X ID 1/2 Not ENT04 67 Identification Code X AN 2/17 Not ENT05 98 Entity Identifier Code X ID 2/2 Not ENT06 66 Identification Code Qualifier X ID 1/2 Not 01/28/2015 V/R 003030 12 FCA US

ENT07 67 Identification Code X AN 2/17 Not ENT08 128 Reference Number Qualifier X ID 2/2 Not ENT09 127 Reference Number X AN 1/30 Not 01/28/2015 V/R 003030 13 FCA US

Segment: RMR Remittance Advice Accounts Receivable Open Item Reference Position: 150 Loop: RMR Optional Level: Detail Usage: Optional Max Use: 1 Purpose: To specify the accounts receivable open item(s) to be included in the cash application and to convey the appropriate detail Syntax Notes: 1 If RMR02 is present, then RMR01 is required. Semantic Notes: 1 If RMR03 is present, it specifies the open item(s) to be included in the cash application. Comments: 1 Parties using this segment should agree on the content of RMR01 and RMR02 prior to initiating communication. 2 If RMR03 is not present, the item referenced in RMR02 is to be included in the cash application. 3 RMR04 is the amount paid. 4 RMR05 may be needed by some payees to distinguish between duplicate reference numbers. 5 RMR06 may be used to specify discount taken. RMR01 128 Reference Number Qualifier X ID 2/2 Code qualifying the Reference Number. VT Motor Vehicle ID Number RMR02 127 Reference Number O AN 1/30 Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier. Vehicle VIN Number RMR03 482 Payment Action Code O ID 2/2 Not RMR04 782 Monetary Amount O R 1/15 Monetary amount Payment amount for the VIN specified in RMR02. RMR05 777 Total Invoice or Credit/Debit Amount O R 1/15 Not RMR06 780 Amount of Discount Taken O R 1/15 Not 01/28/2015 V/R 003030 14 FCA US

Segment: REF Reference Numbers Position: 170 Loop: RMR Optional Level: Detail Usage: Optional Max Use: >1 Purpose: To specify identifying numbers. Syntax Notes: 1 At least one of REF02 or REF03 is required. Semantic Notes: Comments: REF01 128 Reference Number Qualifier M ID 2/2 M Code qualifying the Reference Number. AP Accounts Receivable Number CR Customer Reference Number REF02 127 Reference Number X AN 1/30 Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier. If REF01 = 'CR', FCA US assigned control number from work assignments; If REF01 = 'AP', the Crawford payment ID reference number. REF03 352 Description X AN 1/80 Not 01/28/2015 V/R 003030 15 FCA US

Segment: SE Transaction Set Trailer Position: 010 Loop: Level: Summary Usage: Mandatory Max Use: 1 Purpose: To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments). Syntax Notes: Semantic Notes: Comments: 1 SE is the last segment of each transaction set. SE01 96 Number of Included Segments M N0 1/10 M Total number of segments included in a transaction set including ST and SE segments SE02 329 Transaction Set Control Number M AN 4/9 M Identifying control number that must be unique within the transaction set functional group assigned by the originator for a transaction set 01/28/2015 V/R 003030 16 FCA US