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BMS Super Forms B95BPERFI05 2up Blank 1095 B Form with Instructions P6353669BMS-B95BPERFI05 https://cdnimages.opentip.com/full/BMS/BMS-B95BPERFI05.jpg Super Forms B95BPERFI05 2up Blank 1095 B Form with Instructions Blank Form 1095-B. Use this blank laser form for printing form 1095-B. Instructions are preprinted on the back. A 1095-B form must be issued by a self-insured employer with less than 50 full-time employees (including full-time equivalent employees), or by the insurer to employees and to the IRS as proof of healthcare coverage. Order by the number of sheets needed.Note: Please check your software for 1095 Envelope compatibility.Specifications:Construction: Laser BlankForm: 1095-BPages: 1Size: 8 1/2\" x 11\"Forms /Sheet: 2upHorizontal Perforation: 5 1/2\"For the tax form, If you order before May, it will be for previous tax year (2023). If you order after May, it will be for the present tax year (2024). Please make a comment if you need previous year\'s form. 6353669 0.0200lbs 0.00 0.00 0.00
Super Forms
3.25 2025-03-28 In Stock

Super Forms B95BPERFI05 - 2up Blank 1095-B Form (with Instructions), Price/EA

Brand Super Forms
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SKU: BMS-B95BPERFI05
Unit Price: $0.13
Min.Order Price: $3.25 for 25 units
Quantity:
In Stock
* This item must be ordered in multiples of 25.
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Product Description

Price is for EA.

Blank Form 1095-B. Use this blank laser form for printing form 1095-B. Instructions are preprinted on the back. A 1095-B form must be issued by a self-insured employer with less than 50 full-time employees (including full-time equivalent employees), or by the insurer to employees and to the IRS as proof of healthcare coverage. Order by the number of sheets needed.

Note: Please check your software for 1095 Envelope compatibility.

Specifications:
Construction: Laser Blank
Form: 1095-B
Pages: 1
Size: 8 1/2" x 11"
Forms /Sheet: 2up
Horizontal Perforation: 5 1/2"

For the tax form, If you order before May, it will be for previous tax year (2023).
If you order after May, it will be for the present tax year (2024). Please make a comment if you need previous year's form.

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.

Specifications

Return Policy

Dated products, including tax forms, must be exchanged or returned unopened by December 1.
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