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ABC Laser Blank ACA Form 1095 W/Backer – Deluxe

$35.00$115.00

  • Meets ACA reporting requirements by functioning as both 1095B and 1095C forms
  • Comes with a durable backer to ensure form rigidity and protection of printed information
  • Perfect for tax professionals, employers, and healthcare providers who need to provide accurate health coverage information
  • Made with pride in USA

​The Laser Blank ACA Form 1095 W/Backer is designed to meet your reporting requirements under the Affordable Care Act (ACA).​ This versatile form serves as either a 1095B or 1095C depending on your software settings, providing the flexibility needed for comprehensive healthcare coverage reporting.

This blank form comes with a sturdy backer, ensuring that your printed data is protected during handling and storage. The dimensions of the form are 8 1/2 inches by 11 inches, making it compatible with standard laser printers. 

Quantity

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