New Project Proposal Form

rev. 1/19/2007 PP No. ______

(Secretariat Only)

ASC X12

NEW PROJECT PROPOSAL FORM

for X12 DEVELOPMENT PROJECTS

PROCEDURE: Only X12 subcommittees may use this form to register new development activities as X12 project proposals (PPs). Complete all pages. PPs approved by the X12 Procedures Review Board will be registered and assigned a PP number by the Secretariat.

SUBMISSION: Submit to the Secretariat in advance of a trimester X12 meeting for distribution to the PRB. For submission at an X12 meeting, refer to Procedures Review Board documentation requirements.

Date Submitted to DISA:______

Associated DM (if any):______

Date Approved by Subcommittee:______SC Officer Initials: ______

Subcommittee Name:______

Task Group Number and Name:______

Joint Development Subcommittee (if any):______

INDICATE ONE:

(a) X12 Transaction Set(c) X12 Control Structures(e) CICA/XML Template

(b) X12 Management Transaction Set(d) X12 Guideline

INDICATE ONE:

Transaction Set is X12 Syntax___ Yes ___No

Transaction Set is X12 CICA/XML Syntax ___ Yes ___No

Project Working Title:______

______

Project Delegate for This Project To Be Named on Transmittal Form (Only one alternate may be designated.):

Primary:Alternate:

Name ______Name ______

Company ______________Company ______

Address ______Address ______

Address ______Address ______

Address/ZIP _____________/ZIP+4_____Address/ZIP ______/ZIP+4_____

Telephone ______________Telephone ______

Page Two

Part I PURPOSE AND SCOPE: This statement must indicate the full range of functionality of the new standard or guideline. List any limitations in scope. Explain the transaction, template or application to be covered. For a new transaction set, THE PURPOSE/SCOPE STATEMENT MUST BEGIN AS FOLLOWS: "This X12 Transaction Set contains the format and establishes the data contents of the [title of the standard, transaction set ID] for use within the context of an Electronic Data Interchange (EDI) environment. This standard can be used to..."

Part II BACKGROUND: Provide details that will be helpful in reviewing the proposal. Who are the expected users? How will the transaction, guideline or template be used? What business function(s) does it serve or support? If the proposed standard overlaps the functionality of an existing standard or one in development, provide justification.

Part III OTHER STANDARDS INVOLVED: If applicable, identify any other business information standards that are similar/related to the proposal, and name standards developers (e.g., ANSI Accredited Standards Committees) whose activities may be involved or affected.

Part IV EXPECTED CONTENT/GENERAL DESCRIPTION: (OPTIONAL) Submitter may attach a preliminary draft of the proposed standard or other supporting documentation. Discuss new segments, data elements, control structures, and changes to X12.5, X12.6, X12.3 and X12.22 that are anticipated. (Use attachments.)