| BillingPeriod | The period covered in this bill. |
| CheckDt | The date on the check. |
| CheckNumber | This is used to represent the unique number imprinted on the check or draft. |
| CollectedByAgentAmt | The amount of deposit actually collected by the agency. |
| DayMonthDue | The day of the month when the payment is due. |
| DepositAmt | The actual amount of the deposit. |
| DepositMethodPaymentCd | A code identifying the means by which the deposit portion of the total amount due was/will be made. This element uses the MethodOfPayment code list. |
| Description | A text description the explicit meaning of which is implied by its usage. |
| DownPaymentPct | A percentage of the total premium that the insured is expected to make as a down payment for the coverage provided. |
| ElectronicFundsTransfer | The Electronic Funds Transfer aggregate contains detail information about the electronic funds transfer. The EFT may be a payroll deduction or payments to/from bank accounts or credit cards. |
| FirstPaymentDueDt | The date on which the first installment payment is due. |
| InstallmentFeeAmt | The Installment Charge if it is a fixed currency value. |
| InstallmentInfo | This aggregate contains installment information concerning a specific installment. |
| InstallmentPct | The Installment Charge if it is a percentage of total premium. |
| LOBCd | A code identifying the line of business classification. This element uses the LineOfBusiness code list. |
| LOBSubCd | A code identifying the line of business subcode that further refines the line of business code. The code identifies the product classification of the policy. This element uses the LineOfBusinessSubCode code list. |
| MethodPaymentCd | A code identifying the means by which the payment was/will be made. This element uses the MethodOfPayment code list. |
| NextTermPaymentPlanCd | A code identifying the frequency of billing or payment for the next policy term. This element uses the Frequency code list. |
| NumPayments | Number of payments to be made until the total premium has been paid. |
| PaymentIntervalCd | The frequency at which payments will be made. This element uses the Frequency code list. |
| PaymentPlanCd | A code identifying the frequency of billing or payment. This element uses the Frequency code list. |
| PayorPhysicalRecordInd | Indicates if the payor requires a physical record of the transaction. |
| PostmarkDt | The date stamped by the postal service depicting when an item is marked as received. |
| ReturnPremiumMailCd | A code indicating where the returned premium should be mailed. This element uses the Payor code list. |
| SignatureInfo | This holds information relating to the person who signed and/or completed the form. |
| TaxExemptStateProvCd | A code identifying the applicable state or province in which state or provincial tax is exempted on the entire policy. The source of the code list is the U.S. Postal Service. |
| TotalPaidAmt | The total amount that has been paid. |