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B1094C305 - Form 1094-C - Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns (Page 3)

B1094C305
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Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns. Use the 1094-C Transmittal as a coversheet when filing 1095-C forms to the IRS.

NOTE: This is page one of a three-page transmittal. A kit of all pages can be found here: 1094-C All Pages