| Name | Description | Type | Additional information |
|---|---|---|---|
| employerId | string |
None. |
|
| effMonth | string |
None. |
|
| effDay | string |
None. |
|
| effYear | string |
None. |
|
| companyName | string |
None. |
|
| groupNumber | string |
None. |
|
| firstName | string |
None. |
|
| lastName | string |
None. |
|
| contactTitle | string |
None. |
|
| isSignature | boolean |
None. |