| # | Id | Type | Description |
| 1 | paymentSettlementEntity | boolean | Check to indicate if FILER is a Payment Settlement Entity (PSE) |
| 2 | electronicPaymentFacilitator | boolean | Check to indicate if FILER is an Electronic Payment Facilitator (EPF) / Other third party |
| 3 | paymentCard | boolean | Check to indicate transactions reported are: Payment card |
| 4 | thirdPartyNetwork | boolean | Check to indicate transactions reported are: Third party network |
| 5 | pseName | string | PSE's name |
| 6 | psePhone | TelephoneNumberPlusExtension | |
| 7 | accountNumber | string | Account number |
| 8 | grossAmount | number | Box 1a, Gross amount of payment card/third party network transactions |
| 9 | cardNotPresent | number | Box 1b, Card Not Present Transactions |
| 10 | merchantCategoryCode | string | Box 2, Merchant category code |
| 11 | numberOfTransactions | number | Box 3, Number of purchase transactions |
| 12 | federalTaxWithheld | number | Box 4, Federal income tax withheld |
| 13 | monthAmounts | Array of MonthAmount | Box 5, Monthly amounts |
| 14 | stateAndLocal | Array of StateAndLocalTaxWithholding | Boxes 6-8, State and Local tax withholding |
| 15 | secondTinNotice | boolean | Second TIN Notice |