1095-C ELECTRONIC PREFLIGHT
Employer / year / batch / approved version:
Operation / environment / channel:
Final file reference / technical specification versions:

RECORD CROSSWALK
Internal employee-employer key | Approved version | Submission | Record ID | Receipt reference when received

COUNTS
Approved records / generated records / accompanying count:
Missing / extra / duplicate original assignments:
Conditional covered-person data compared:

CHECKS
[ ] Final export matches approved facts
[ ] Generated crosswalk matches actual ordering
[ ] Complete submission-plus-record context retained
[ ] Final-file validation evidence available
[ ] No overlapping active original release
[ ] Unresolved exceptions disposition recorded

RELEASE
Actual operator / time / approval:
Response / receipt / UTID:
Acknowledgment reviewer / next action: