skip to footer block
CYR ComplyRight 1095BC 1095 B "Employee/Employer" Health Coverage "Continuation" Pack of 100 P12205133CYR-1095BC https://cdnimages.opentip.com/full/CYR/CYR-1095BC.jpg ComplyRight 1095BC 1095 B "Employee/Employer" Health Coverage "Continuation" Pack of 100 Manufacturer Part Number: 1095BC*1095-B CONTINUATIONContinuation sheet supplements the Affordable Care Act Tax Form to register health coverage with the Internal Revenue Service. This 1094-B Transmittal for 1095-B form includes prompts for covered individuals: name, social security number, date of birth and months of coverage. It is printed in black ink and is compatible with laser printers. 12205133 1.1000lbs 0.00 0.00 0.00
ComplyRight
16.8000 2025-05-12 In Stock
ComplyRight 1095BC 1095-B "Employee/Employer" Health Coverage "Continuation", Pack of 100, Price/100 Forms

ComplyRight 1095BC 1095-B "Employee/Employer" Health Coverage "Continuation", Pack of 100, Price/100 Forms

Brand ComplyRight
Shop more from CYR

SKU: CYR-1095BC
Price: $16.80
Pack:
Quantity:
Shipping:
$16.71 To [ 43215 ] Estimated Delivery Date: May 20, 2024 to May 22, 2024
In Stock
Share & Earn 10% Cash Back Best Price in Bulk

Product Description

Price is for 100 Forms.

Manufacturer Part Number: 1095BC

*1095-B CONTINUATION

Continuation sheet supplements the Affordable Care Act Tax Form to register health coverage with the Internal Revenue Service. This 1094-B Transmittal for 1095-B form includes prompts for covered individuals: name, social security number, date of birth and months of coverage. It is printed in black ink and is compatible with laser printers.

warning tips WARNING: This product can expose you to chemicals which are known to the State of California to cause cancer, birth defects, or other reproductive harm. For more information, go to www.p65warnings.ca.gov.
Need more information?
Our staff are available to answer any questions you may have about this item


Customer Reviews
0 reviews
Be the first to review this item!