Form 1095-C Recipient Continuation

(95CRCCNP)
1095-C Recipient continuation form for use with 95CRCBT when there are more than 6 covered individuals. Portrait style, use B1095CCON05 with Federal landscape copy.
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1 / Free Sample
25 - 49 / $0.624
50 - 99 / $0.371
100 - 199 / $0.334
200 - 499 / $0.309
500 - 999 / $0.1928
1000 - 1999 / $0.1724
2000 - 4999 / $0.1673
5000+ / $0.1591
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