FIRE SOURCE PREFLIGHT

Batch label: _____________________  Reviewer/date: _____________________
Original file location: ___________  Working copy location: _____________
Exporter/software: ________________  Exported at: _______________________
File size/hash reference: _____________________________________________
Payment year: __________  Source specification/revision: _______________
Expected forms: __________  Payers: ______  Original/correction: _______

[ ] Source copy unchanged and linked to the export report.
[ ] Source scope agrees with requested filing scope.
[ ] Converter form/year/indicator coverage checked.
[ ] Logical record boundaries and final record checked.
[ ] Encoding/line endings checked without resaving the original.
[ ] Counts reconcile by payer and form.
[ ] Each populated federal box total reconciles.
[ ] State data and unusual records reviewed separately.

Payer key | Form | Expected count | Source count | Amount field | Expected | Source | Difference
__________|______|________________|______________|______________|__________|________|___________

Exception | Source record reference | Needed action | Assignee
__________|_________________________|_______________|_________

Decision: ready for conversion / re-export requested / alternative needed
Unresolved issues: ___________________________________________________
This is a preparation worksheet, not an IRS acceptance test.