Laser 1094-C Transmittal Employer Provded Health Ins

Meet your reporting requirements under the Affordable Care Act (ACA). A Summary Transmittal is required for submitting 1095C forms to the IRS.

All 1095C submissions mailed to the IRS must be accompanied by a Summary Transmittal form 1095B.

This transmittal includes 3 pages, with backers per transmittal. Send to IRS, along with your 1095-C forms. 

• Item #  TF5500
• Size: 8 1/2 x 11"
• One transmittal equals 3 pages
• Tax Forms per Sheet: Two filings per sheet
• Use with 1095C submissions only.
• Use to Report: Wages, tips, and other compensation
• Meets all government and IRS filing requirements
• All 1095C submissions mailed to the IRS must be accompanied by a Summary Transmittal form 1095B.