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X12 164 — Revenue Receipts Statement

Consolidated statement of revenue collected on behalf of a third-party entity. Per-account detail, per-period, with tax and fee breakdown.

Purpose

Used by collecting entities (Third-Party Processors, fiscal government agencies, fiduciary banks) to report to their principals the collected revenue. Per-account detail, per-period, with tax/fee breakdown, individual or aggregated transactions.

Envelope structure

The 164 travels inside the three X12 envelope levels (ISA/IEA, GS/GE with functional group RV, and ST/SE). Didactic example in 004010:

x12 example-164.x12
ISA*00*          *00*          *ZZ*COLLECTOR     *ZZ*PRINCIPAL01   *260516*2100*U*00401*000000164*0*P*>~
GS*RV*COLLECTOR*PRINCIPAL01*20260516*2100*1*X*004010~
ST*164*0001~
BPS*RV*STMT-2026-04*20260516~
DTM*194*20260401~
DTM*195*20260430~
REF*AC*ACCT-12345~
AMT*RV*12500.00~
AMT*TX*1000.00~
AMT*FE*125.00~
SE*7*0001~
GE*1*1~
IEA*1*000000164~

Common segments

  • HeaderST, BPS Beginning of Receipts Statement.
  • PeriodDTM*194 start, DTM*195 end.
  • Account loopREF*AC.
  • ReceiptsAMT*RV revenue, AMT*TX tax, AMT*FE fee.
  • SummarySE.

Common pitfalls

  • Open period: without DTM*194/195, the statement is ambiguous (cumulative? monthly?).
  • Net vs gross revenue: specify whether AMT*RV is pre- or post-fee.
  • No tax breakdown: some regulators require splitting State vs federal tax.

Documentation

The 164 code and the Revenue Receipts Statement name are public and listed at x12.org/products/transaction-sets. The full loops/qualifiers/code-lists structure is distributed by DISA via proprietary Implementation Guides (TR3). ediverse.io covers only public concepts, the envelope and didactic examples.