﻿<?xml version="1.0" encoding="utf-8"?>
<eFormsAck>
	<Header>
		<APIHeader>
			<SubmitterClientId />
			<SenderPOI />
			<SubmitDate />
		</APIHeader>
		<BatchHeader>
			<SenderPOI />
			<ReceiptDate />
			<ProcessStartDate />
			<ProcessEndDate />
			<FileId />
			<FileName />
			<EventCount />
		</BatchHeader>
	</Header>
	<FileStatus></FileStatus>
	<FileStatusMessage></FileStatusMessage>
	<Events>
		<EventCode code="RFA-1LC">
			<WCBCaseID />
			<TransactionSequenceNumber/>
			<SubmissionId/>
			<SubmissionStatus/>
			<FormImage/>
			<Errors>
				<Error>
					<FileErrorIndicator/>
					<ReasonCode/>
					<DataElementName/>
					<ErrorCode/>
					<ErrorText/>
					<ErrorDescription/>
					<ErrorSegmentIndex/>
					<ErrorSegmentChildIndex/>
				</Error>
			</Errors>
		</EventCode>
	</Events>
</eFormsAck>