Form 1094-C - Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns - Page 3

(B1094C305)
Form 1094-C
Use the 1094-C Transmittal as a coversheet when submitting multiple 1095-C forms to the IRS.

NOTE: This page three of a three-page transmittal. Click Here for the complete set.

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