"Employee SSN"	"Employee Last Name"	"Employee First Name"	"Employee Middle Initial"	"Employee Address Line 1"	"Employee Address Line 2"	"Employee City"	"Employee State"	"Employee Zip Code 1"	"Employee Zip+4"	"Employee Foreign Country Code"	"Employee Foreign Zip Code"	"Employee Date of Hire"	"Employee Date of Birth"	"Employee Gender"	"Employer Name"	"Employer Payroll Address Line 1"	"Employer Payroll Address Line 2"	"Employer Payroll City"	"Employer Payroll State"	"Employer Payroll Zip Code 1"	"Employer Payroll Zip+4"	"Employer Foreign Country Code"	"Employer Foreign Zip Code"	"Employer FEIN"