Tops 1095B Continuation Sheet

Mfg Part #:	L1095BCONT
Our Part #:	TOPL1095BCONT
Manufacturer:	Tops
Health Coverage 1095B Continue Form, 8-1/2"x11", 40/PK, WE. 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.
Office Depot :	$ 13.99
Our Price:	$ 8.67
You Save:	$ 5.32(38%)
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