Laser 1095B ACA Continuation Sheets

Name: Laser 1095B ACA Continuation Sheets
Brand: SR
SKU: TF5095C
Price: 29.0 USD
Availability: InStock

Sku: TF5095C

TF5095C

This product is out of stock until 9/4/2026. Contact us to see if we can create a suitable alternative.

Qty	Price	Unit Price
25	$29.00	$1.16
50	$34.00	$0.68
100	$44.00	$0.44
150	$54.00	$0.36
200	$67.00	$0.34
250	$79.00	$0.32
300	$85.00	$0.28
350	$99.00	$0.28
400	$112.00	$0.28
450	$126.00	$0.28
500	$138.00	$0.28

Description

This form is used to fulfil reporting requirements under the Affordable Care Act (ACA). Use this form to report employees covered by your health plan.

Specifications

Product Details

Size: 8 1/2" x 11"
Continuation form is used in addition to 1095B when an employee has more than 6 dependents
One filing per sheet
Shrink wrapped in packs of 25
Government approved 20# bond paper
Compatible with laser or inkjet printers
Meets all government and IRS filing requirements

Filings Per Page

One

Use

1095-C

Min. Quantity

Turnaround Time:

Product #	Turnaround
TF5095C	2 business day(s)