$11.99/Pack

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Product Overview

  • Required under the Affordable Care Act
  • Reports on whether or not an employer offered health coverage to employees
  • Form provides a copy of the report for employees and employers
  • Issued by employers with 50 or more full-time employees
  • Must be submitted by 2/28 via mail or 3/31 electronically
UPC Code:400015412711
View all ComplyRight Employee Management and Compliance Forms

ComplyRight 1095C50 Specs

Quantity
50/Pack
Shipping Weight
1 lb.
Length
11 Inches
Width
8 1/2 Inches
Features
Made in America
Language
English
Material
Paper
Shape
Rectangle
Type
Tax Forms

ComplyRight 1095C50 Details

Provide essential tax records with this ComplyRight 8 1/2" x 11" 1095-C employer / employee copy of employer-provided health insurance offer and coverage laser tax form. Required under the Affordable Care Act, this document reports on whether or not an employer offered health coverage to employees. This form provides employers and employees with a copy of this important information.

At a standard 8 1/2" x 11" size, this form can be easily folded down to fit in a mailing envelope. It is made on laser paper for a crisp finish. Plus, 50 forms per pack are included for long-lasting use. This form should be submitted by February 28 via mail or March 31 electronically.

Overall Dimensions:
Length: 11"
Width: 8 1/2"

Attention CA Residents:

Attention CA Residents

WARNING:This product can expose you to chemicals including lead, which are known to the State of California to cause cancer and birth defects or other reproductive harm. For more information, go to www.p65warnings.ca.gov.

  • Made in America

    Made in America

    This item was made in the United States of America.

Resources for
ComplyRight 1095C50

  • Restaurant Recruiting Guide