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TF5096C 2022 Laser 1095C ACA Continuation Sheet 8 1/2 x 11" QTY 25

TF5096C 2022 Laser 1095C ACA Continuation Sheet 8 1/2 x 11" QTY 25

$16.45

TF5096C 2022 Laser 1095C ACA Continuation Sheet
Size: 8 1/2 x 11"
This form is used in addition to the 1095C when an employee has more than 6 dependents.
Meet your reporting requirements under the Affordable Care Act (ACA) by using this form to report whether employees were offered health insurance.
ages paid.

 

    • 1-sided form
    • Black ink imprint
    • Laser form - for original 1095C forms see product TF5096
    • For employers with 50 or more full-time employees (FTEs) that worked at least one month during the year, that have more than 6 dependents.
    • For self-insured employers, with 50 or more full-time employees that worked at least one month during the year, that have more than 6 dependents.
    • This form is not available in multiple copies.  You must order for the total number of copies you need (ex. 50 employees - in most cases you will need one copy for the employee, one for the employer, and one for the IRS so you must order quantity 150).
    • Compatible with laser or inkjet printers.
    • 1 filing per sheet
    • 25 per pack


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