Tops 1095B Affordable Care Act Tax Form

Mfg Part #:	L1095B
Our Part #:	TOPL1095B
Manufacturer:	Tops
Health Coverage Forms 1095B, 50/PK, White. Affordable Care Act Tax Form is a required form to register health coverage with the Internal Revenue Service. This 1095-B form includes prompts for information about the responsible individual; employer sponsored coverage; issuer or other coverage provider; and covered individuals. It is printed in black ink and is compatible with laser printers.
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